Forms and Policies

To become a new Parkwood Pediatric Group family, we will need the following information: 

1. All existing medical records for your child, including up-to-date immunization records.
2. A signed copy of our Vaccination Policy.
3. A completed Authorization for Release of Information for each child.
4. A front and back copy of your health insurance card. (Please contact your insurance provider directly to confirm Parkwood Pediatric Group is in-network for your policy).
5. A completed New Patient Packet for each child. Please bring this packet to your first visit. We require all patients to have a shot record on file prior to their appointment.

Once we have received all prospective paperwork, we will contact you to register your family and schedule any needed appointments. Once we have received the above information our medical records staff will reach out to you. If you have not heard from us in 5-7 business days, please give us a call.

NOTE: Please read our Vaccine Policy carefully. At Parkwood Pediatrics, we strive to provide the best care possible, and we feel that includes preventing serious disease with vaccines. If you have questions regarding vaccines that you would like to discuss with your child’s doctor, please do not hesitate to ask! We are always ready and willing to have a discussion and answer any concerns you may have.

If you do not wish to vaccinate your children after discussing all questions with your physician, we will kindly ask that you find a practice which better aligns with your values.

For thorough and valid vaccine information, please visit the website below:

Children’s Hospital of Philadelphia Vaccine Education Center

For all requests made on the portal, please allow 48 hours for medication refill (including all ADHD med requests) and form completion requests. Please allow 72 hours for all immunization record requests.

We kindly ask you do not call back to check on the status of your requests until AFTER the 48 hour or 72 hour time period.

Thank you!