Capital Pediatrics New Patient Information

To expedite your child’s first appointment, we are happy to make our New Patient Packets and Privacy Policy available online.  Please print and complete the forms below.  Please bring your child’s completed New Patient Packet, as well as the requested information, to your child’s first appointment.  Should you have any questions, please don’t hesitate to call the clinic where your child will be seen and someone will be happy to help you.  We look forward to meeting you and your child – welcome to our practice!

Please click the PDF icons below to download the documents:


Privacy Policy  

New Patient Packet


Please bring the following to your child’s appointment:

  • Insurance Card
  • Immunization Record
  • Child’s Birth Certificate (Newborns)
  • Photo ID (Parent / Guardian)
  • Foster Parents / Legal Guardian must have Guardianship / Custody Agreement paperwork (At all times)