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EUREKA PEDIATRICS

Signed in as:

filler@godaddy.com

  • Home
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  • Contact Us
  • Services
  • Forms and Photos

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  • My Account

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Photo Gallery

    Patient Forms

    PATIENT INFO (doc)Download
    HIPPA (doc)Download
    CONSENT (doc)Download
    VACCINE POLICY (doc)Download
    FINANCIAL AGREEMENT (pdf)Download
    HEALTH HISTORY (pdf)Download
    NO SHOW POLICY (doc)Download
    RECORD RELEASE-NEW TO US (doc)Download
    NEWBORN HEALTH (doc)Download
    RECORD RELEASE FOR CERTAIN INFORMATION (pdf)Download
    RECORD RELEASE-LEAVING US (doc)Download
    PRIVACY STATEMENT (doc)Download
    TELEHEALTH CONSENT FORM (pdf)Download

    PATIENT SURVEYS

    TIPS FOR PARENTS WITH ADHD (pdf)Download
    VANDERBILT-PARENT INITIAL (pdf)Download
    VANDERBILT-TEACHER INTIAL (pdf)Download
    ASTHMA FORM -4 TO 11 (pdf)Download
    ASTHMA FORM-12 AND UP (pdf)Download
    CRAFFT SURVEY (pdf)Download
    GAD-7 SURVEY (pdf)Download
    PHQ-9 SURVEY (pdf)Download
    SCAT 2 (pdf)Download

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