Pediatric Associates of Franklin, NC
PATIENT FORMS

In an effort to save you time, Pediatric Associates of Franklin, P.A., has provided several forms to help you prepare for your office visit. The forms are in PDF format and may be viewed and printed via Adobe Acrobat Reader. Please complete the form (or forms) that best represent your upcoming appointment and bring it with you to help reduce your waiting time.

• New Patient Form » en espanol
• Patient Consent Form » en espanol
• Medical Release Form » en espanol
• Sports Physical Form
• School Medication Form
• Financial Policy » en espanol

Other Things to Remember

Please remember to also bring your most current insurance card to ensure the information (group number, provider number, etc.) is valid at the time of service. Incorrect or out-of-date information will delay your claim and you may be held responsible for full payment of the claim. Your insurance card is similar to a credit card - the information must be valid in order for it to be used. If we do not have the most up-to-date insurance information, it makes it difficult to process claims.