New Patient Forms

 
ATTENTION: IF PARENT OR GUARDIAN IS NOT BRINGING CHILD TO THE APPOINTMENT, WE NEED WRITTEN CONSENT PRIOR TO THE APPOINTMENT.
 
  • Person bringing child must be 18 years of age or older.
  • Must bring ID and the permission letter provided by the parent or guardian of the child.

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It is not required to print paperwork to bring to the office. Please bring insurance card(s) and parent photo ID to every appointment.

HIPPA NOTICE

 

Updated: 1-Sep-2014

Download form

OCPA PATIENT FORMS

Updated: 16-October-2020

Dr. Kumar
Dr. Walters

MEDICAL RECORD RELEASE FORMS

Updated: 16-October-2020

Release to OCPA
Release from OCPA

SURGERY PATIENTS

  • You will receive a phone call the day before the surgery to give exact arrival time.
  • Child cannot have anything to eat or drink after midnight, surgery may be cancelled otherwise.
DOWNLOAD SURGERY FOLDER