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Pediatrician - Raleigh (919) 782-5273 |
Pediatrician - Knightdale (919) 781-8853 (fax) |
Pediatrician - Wakefield
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SICK CHILD?
View the KidsDoc Symptom Checker from HealthyChildren.org
Patient Forms
Well Child Check-ASQ Developmental Screening Forms
- ASQ 2 Months
- ASQ 4 Months
- ASQ 6 Months
- ASQ 9 Months
- ASQ 12 Months
- ASQ 16 Months
- ASQ 18 Months
- ASQ 24 Months
- ASQ 48 Months
- ASQ 60 Months
School Forms
- Children's Medical Report DCD
- Wake County Enrollment Forms http://www.wcpss.net/Page/275
- Wake County Middle and High School Athletic Participation
- Wake County School Medication Form
- Johnston County High School Sports Participation Form
- Johnston County School Medication Form
ADHD Forms
Initial Evaluation Forms
- NICHQ Vanderbilt Initial Assessment Scale Parent Informant
- NICHQ Vanderbilt Initial Assesment - Teacher Informant
Follow-Up Evaluation Forms
- NICHQ Vanderbilt Follow Up - Parent Informant
- NICHQ Vanderbilt Assessment Follow-up Teacher Informant
New Patient Forms
- Authorization to Release Information Form
- Insurance and Your Pediatrician New Patient Form
- Demographic Update Spanish
- Demographic Update English
In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it.
APPOINTMENT REQUEST
We've made requesting an appointment easy. Simply click below to request your appointment now.
EXPECTING?
Choosing a pediatrician is an important and personal decision and we want you to feel at ease with the care you and your child will receive.
PARENT RESOURCES
An online resource center providing you with additional helpful information.
PATIENT EDUCATION
Happy New Year to all- Winter Season is upon us and there may be times that we have to delay or close for inclement weather. We would like our patients to know that we will make every effort to see all patients that need to come. We will post our delays or closings on WRAL and WTVD news. You will not receive a call but you can call the office at the posted opeing time to reshedule. We will also keep our night triage service on the phone system while we are closed. They can not make appointments but they can triage all calls for any concerns. Please do not hesitate to call us during working hours or send an email through our website.
CONTACT US
Questions or Comments?
We encourage you to contact us whenever you have an interest about our services.
Call (919) 782-5273
Offices in Raleigh and Knightdale