NEW PATIENTS:
Fill out and submit the forms below AFTER receiving your appointment confirmation via text message. These help us prepare for your first visit with us and ensure that you can see the provider quickly.
Parents of Newborns, submit a Newborn Insurance Enrollment Declaration.
If you are transferring care to Northside Pediatrics from a previous provider, submit our Authorization to Release Medical Records.
Send us Vaccination or Medical Records. If you are new to Texas, also submit the Texas Immunization Registry (ImmTrac2) Registration Form [PDF]. Upload completed forms and records here.
OR E-mail the vaccination/medical records and discharge papers to our secure email address: [email protected] with subject header: Patient Name + Names of Documents being sent.
OR Bring your completed forms, vaccine records and any Newborn or Hospital Discharge Papers with you to your first appointment.
