.gif){kind=small}
Patient Forms
Before Your Appointment
The forms listed below can be printed for your convenience. Completing them out beforehand will streamline your visit. If you elect not to fill out these forms ahead of time, please arrive 15 minutes prior to your scheduled time. (Download Adobe Reader for free at www.adobe.com.)
We are dedicated to making your experience smooth, comfortable, and efficient. We've prepared this section to help you learn more about the administrative aspects of your child's care.
Please browse our forms and policies. If you are a new patient we encourage you to print, complete, and return the patient forms before your child's first visit. You may also pre-register on our Patient Portal.
In addition to the patient forms we have provided some information regarding our office policies and general guidelines of our practice. These policies are in place to allow us to serve you better and help us deliver the best medical care possible to your child.
Please call our office at 623-362-1818 if you have any questions.
Return Your Forms:
Mail to Office:
Valley of the Sun Pediatrics
6635 W. Happy Valley Rd. Ste A104-503
Glendale, AZ 85310
Printable Office Forms
New Patient Packet
Consent Form
Consent to Share Information with Parents (18 year olds)
Medical Record Release Form
Office Policy Summary
Past Medical History Form
Patient Eligibility Screening Record Vaccines for Children Program
Patient Information Form
Secondary Insurance
Unaccompanied Child Authorization (Ages 16-18 years)