Patient Forms — Complete Before Your First Visit
Welcome to Happy Days Pediatrics. To help make your first visit as smooth and efficient as possible, please download and complete each of the forms below before your appointment Completed forms may be prior to your visit.
If you are not able to complete the forms in advance, please arrive 15 minutes early on the day of your appointment to allow time to fill them out in the office. If you have any questions about which forms apply to your child, call our team at (210) 816-1330 — we are happy to help.
Patient Forms
Please download a copy of each of the forms, fill them out bring completed forms to your first appointment
New Patient Demographic
Basic contact, insurance, and patient information
Health History
Your child's medical history, allergies, medications, and family history
Medical Release
Authorization for release of medical records
Credit Card Authorization
Authorization for card on file for billing
Appointment Policy Acknowledgement
Our appointment, cancellation, and no-show policy
HIPAA Privacy Notice & Acknowledgement
Federal privacy notice and patient acknowledgement