New Patient Forms – Save Time and Complete at Home

Please fill out all new patient forms and bring them to your child’s first appointment.

Individual Patient Forms:
Patient Registration
Medical History
Consent to Treat and Notice of Privacy
Notice to Parents Regarding Nurse Practitioner
Authorization for Release of Medical Records
Financial Policy
Pediatric Preventative Healthcare Guidelines
Pediatric Authorized for Credit card File Payment
Pediatric Insurance Authorization

Pediatric Center of Round Rock

4 out of 5 stars

Jason Ouellette

4 out of 5 stars

posted 4 days ago

Thankful for the kind and caring employees here, Karen, the business manager was very helpful with a billing matter - they are genuinely dedicated to good customer service.

Daphne Zuniga

4 out of 5 stars

posted 1 month ago

I love this office! The doctor's are very friendly and good at their job. They love my daughter and she loves them. I'd give them 5 stars if it werent for the older receptionist. Every time I call and she is working I get put on hold for AT LEAST 10 minutes. One time I had to call back 3 times because I was on hold so long it hung up in me. She is a very nice lady but is lacking the ability to multi task. Besides taking forever to schedule an appointment this place is amazing! You get in and out quick. Ive never had an appointment last longer than 45mins.

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