About Our Practice

• Meet our Staff
• Map and Directions.
• Consent for Treatment.
• Contact Us.

Forms for download

These documents available for download on your computer are in PDF format.

New Patient Registration Forms (non-newborn)

• Patient Registration Form
• Pediatric Health History Form
• Medical Record Release Authorization

Newborn Patient Registration

• Patient Registration Form

To Retrieve Medical Records
from Starks Pediatrics

• Medical Record Request Form

Office Policies

• Our Financial Policy
• Notice of Privacy Practices
• Patient Rights & Responsibilities

The above forms require return through email or printing & returning to our office.