Patient Forms

Please complete the following forms before your first visit at Wildflower Pediatrics. These forms can be printed out and completed by hand. Bring them to your first visit and we will upload them into your child’s electronic medical record. There is a total of 8 forms. The “Medical Release Authorization Form” is only required if you need to transfer your child’s medical records from another practice to Wildflower Pediatrics. Only the last page of the “Wildflower Privacy Policy” form needs to be printed out and signed after review.

These forms will also be available at the Patient Engagement Site at the link,, after you have registered your child (see detailed instructions under the blog section on the homepage). In the near future, we hope to improve our new patient registration process, creating electronic access to these forms and automatic transfer into our electronic medical records system (Athena Health). We appreciate your patience with this process.