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Establishing Care as a New Patient

We’re so glad you’re here! At Hirschfield Pediatrics & Family Care, we provide compassionate, personalized healthcare for children and their families. This page will help guide you through what to expect as a new patient. We’re here to make every step smooth, supportive, and stress-free.

Before Your Visit

To help make your first appointment smooth and stress-free, we’ve provided all the necessary forms you can complete in advance. Filling out these documents ahead of time allows us to better prepare for your visit and spend more time focusing on your child’s care.

Please download, print, and complete the following forms before your scheduled visit and bring them with you at your appointment. If you have any questions while filling them out, don’t hesitate to contact our office—we’re happy to help.

  1. New Patient Information Sheet Basic details about your child and family

  2. Consent for Treatment Authorizes us to provide medical care

  3. HIPAA Consent FormDescribes how we protect your privacy and handle medical information

  4. Medical Records Request Form Allows us to request past records from previous providers

Checklist

Here are a few things to ensure before your visit:

  1. Click here to check if your insurance is accepted or

  2. Check out our Plans & Pricing page to choose your choice of payment method

  3. Fill out the required new patient forms (see above)

  4. Book your appointment online by clicking here or call our office at (727)-851-6160

Here are a few things to ensure when you arrive:

  1. Bring your insurance card

  2. Any pertinent forms or records if you have them (e.g. new patient forms, vaccination records, school/sports clearance forms, recent lab results, etc.).
    * Note: if you received your vaccines in Florida and do not have a copy of your vaccination records, we can look it up here at the office. If vaccinated out of state, we can request records after you fill out the Medical Records Request form or you can bring a copy.

  3. We recommended to arrive 10 minutes early 

Please call our office if you have any additional questions

Contact Us:

Hirschfield Pediatrics & Family Care  

6705 38th Avenue North, Ste. A

St Petersburg, FL 33710

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© 2020 Hirschfield Pediatrics & Family Care || Hirschfield Direct

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