Welcome to Fairhope Pediatrics!
Whether you are expecting a new child, have recently moved to our area, or are looking for a new medical home for your children, we thank you for trusting us with your child’s health. We welcome new pediatric and adolescent patients.
New Patient Forms
Please complete this list of new patient forms at your convenience. This includes a records release and a credit card authorization form. We require a credit card on file for all patients.
Once we have received the completed forms, we will request your child’s records from their previous provider. Please note that by law, offices have up to 30 days to send medical records.
As soon as we receive those records and create a chart, we will contact you to let you know we can begin scheduling appointments. If you have any questions, please do not hesitate to call our office at (251) 928-5568.
Office forms are temporarily unavailable.
New Patient Forms
- Please complete the forms below In preparation for your first visit. You will automatically be taken to the next form in the list.
- Patient Demographics
- Health History
- Consent to Treat
- Office Policies
- Vaccine Policy
- Privacy Practices
- Release Medical Records to Fairhope Pediatrics
- Medical/Financial Disclosure
- Credit Card Authorization
Newborns
Our patient liaison visits new parents at Thomas Hospital to schedule your initial appointment, provide paperwork, and answer any questions.
We know there are many questions that arise as you become new parents. Here are some valuable resources provided by the American Academy of Pediatrics that we hope will help you along the way.
Resources for new parents »Newborns
Our patient liaison visits new parents at Thomas Hospital to schedule your initial appointment, provide paperwork, and answer any questions.
We know there are many questions that arise as you become new parents. Here are some valuable resources provided by the American Academy of Pediatrics that we hope will help you along the way.
Resources for new parents »