Open on Saturday Starting August 20th!

  • Home
  • Contact Us
  • Insurance & Self Pay Info
  • Our Team
  • Services
  • Patient Login
  • Forms
  • More
    • Home
    • Contact Us
    • Insurance & Self Pay Info
    • Our Team
    • Services
    • Patient Login
    • Forms
  • Home
  • Contact Us
  • Insurance & Self Pay Info
  • Our Team
  • Services
  • Patient Login
  • Forms

New Patient forms

The forms below can be filled out electronically. You can fill them out, save them to your PC or mobile device, and email them to frontdesk@averymaepediatrics.com

Registration form

Download PDF

Medical history release form

Download PDF

No Show Policy

Download PDF

Vaccination preference

Download PDF

hipaa

Download PDF

Pediatric office in Thompson's Station offering well visits, sick visits, same day appointments, sports physicals, and medical grade ear piercing.