Integrative Pediatrics, LLC
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HIPAA
Notice of Privacy Practices
Acknowledgment and Consent

Financial Policy
Financial Policy

New Patient
Registration Packet (includes Financial Policy, HIPPA Consent, and Patient Registration Form)
New Patient Packet
Patient Health History Form

Records Transfers
To or From Integrative Pediatrics

Immunizations
Visit and Vaccination Schedule at Integrative Pediatrics
Vaccination Glossary
For Information about specific Immunizations, click here


Autism Screening
M-Chat – used to screen for Autisms at 18-24 months

Vanderbilt Assessments – used to screen for ADD and ADHD in school age children
   -Parent Assessment
   -Parent Assessment Follow-Up

   -Teacher Assessment
   -Teacher Assessment Follow-Up

Miscellaneous
Homeopathy History Form
Lead Screening Questionnaire
Portal Registration Instructions
Authorization for Consent to Treatment
Authorization to Use and Disclose Protected Health Information
MVA Billing Information
Non-Discrimination Statement

WSD