Insurance and Forms

The following pages are here so that you can download and fill out prior to your arrival at Maple Avenue Pediatrics.  Having these forms ready will help expedite your time spent at the office.  Check back frequently as some of the information provided will change with the seasons!
 
 

HIPAA Privacy Policy

Acknowledgment of Receipt of Notice of Privacy Practices

New Patient Form

Insurance Alert

Child's Health History

Athletic Physicals Form

Maple Avenue Pediatrics Billing Policy

 

 

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