Thank you for choosing Canyon Pediatrics & Family as your child's medical home, where we always provide a comfortable, caring environment so our patients and their families can feel at ease. We've included helpful items on this page to ensure you and your child's first trip to our office is productive, stress-free and enjoyable.
Our practice is working together to build life-long relationships between our staff and our patients by consistently providing our patients with compassion, excellence and value.
To fulfill this mission, we are committed to:
- Improving the lives of the children we serve by providing quality care in a child-centered environment.
- Listening to our young patients and their families who we are privileged to serve.
- Guiding our patients along a path of optimal health and wellness.
- Continually pursuing excellence at all levels through continuing education.
- Insurance cards
- Complete immunization records
- Medical records from your previous pediatrician
We are happy to provide our office forms for convenient download on your home computer. Please print and complete the forms below, and bring them with you to your child's first appointment. Questions about which forms you need? Please call our office and our courteous staff will assist you in preparing for your child's first visit.
Patient Enrollment Form [Online] [PDF]
Authorization for Use of Disclosure of Protected Health Information [Online] [PDF]
Pediatric Consent Form [Online] [PDF]
Lead Screening Questionnaire (only fill out if your child is 2 years old or younger) [Online] [PDF]
Health History [Online] [PDF]
Registro de Paciente [En línea] [PDF]
Autorizacion Para el Uso de la Divulgacion de Informacion Medica Protegida [En línea] [PDF]
Formulario de Consentimiento Pediatrico [En línea] [PDF]
Cuestionario de Deteccion de Plomo (complete solo si su hijo tiene 2 anos o menos) [En línea] [PDF]
Historia de Salud [En línea] [PDF]
- In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it:
The Initial Visit
Our compassionate pediatricians do whatever it takes to make every visit to our office a pleasant, relaxed experience. With all of the important information about our practice available on our website, you can feel confident that you and child are well-prepared for your first appointment. We also invite you to review our staff page in order to get to know our doctors and staff. We look forward to meeting you.
Canyon Pediatrics is committed to providing quality care to all families. This page contains policies for patients and their families. If you have any questions about these policies or require additional support or information, please let us know at [email protected] or call us at 480-507-2199.