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

4.1 out of 5 stars

Sarah Cason

5 out of 5 stars

posted 1 week ago

My 12 month old has been going to Dr.Salinas she she was a few weeks old. The faculty is always great, Very kind and caring to us. They are very accommodating since we have been going since quarantine. Going to a pediatric doctor during the quarantine was different and unpredictable. Dr.Salinas is informative and always goes over my daughters progress with me. That is a first for any doctor for myself or children. I would recommend this place to friends and family.

Ashley Brite

5 out of 5 stars

posted 4 weeks ago

I have taken 3 foster kiddos to Dr Salinas in the last year and she’s been great! I love that I can get an appointment quickly, the office is clean and the staff is helpful. My most recent foster kiddo doesn’t do great with doctors and Dr Salinas was so patient and accommodating. I would definitely recommend.

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