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Flu Vaccines (Quadrivalent & Preservative-Free) will be available starting October 3rd. All children 6 months and above should receive the flu vaccine annually. Call to make your appointment.
With children back to school and flu season approaching encourage your children to wash their hands more frequently.
Looking for a pediatrician for your unborn child? Make an appointment for a meet and greet with our physicians. We have pre-natal visits every other Thursday at 5:00pm. Please call to make your appointment.

Patient Forms

Please complete and print the following forms PRIOR to your visit.
This will help the staff to expedite your wait time.

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New Patient Forms
HIPAA Privacy Notice

Consent To Treat
If either parent or legal guardian is unable to bring the child in the office this form must be filled out.

Record Request Form
Use this form if you are requesting your child’s records for a transfer either to our practice or from our practice.

HIPAA Privacy Notice
This is a copy of Village Pediatrics Privacy Notice which is in accordance with the law.

Over 18 Confidentiality Agreement
Any patient that is 18 years or older must provide us with this form regarding the confidentiality of their medical records.

Pre-Natal Form
Please fill out this form prior to your meeting with the physicians.

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Looking for a pediatrician for your unborn child? Make an appointment to meet and greet with our physicians. We have pre-natal visits every other Thursday at 5:00pm. Please call to make your appointment.
Check-Up season is here again don’t waste time and book your appointments early for camp and school.
Warm weather is upon us and sunscreen and water safety is very important. All children should have sunscreen applied whenever they are going to be outside and should be reapplied often. Children should never be left unattended near pools, beaches and lakes.