New Patient Information
Kaplan Barron Pediatric Group Forms & Policies
Before your appointment with us, quickly and conveniently access patient forms from our practice.
To view the forms listed below, you will need Adobe Reader. You may download Adobe Reader for free at www.adobe.com. Please bring your completed forms with you to our office at the time of your visit.
Download Patient Forms
- Behavioral Referral for Services
- NICHQ Vanderbilt Assessment Follow-up Parent Informant
- NICHQ Vanderbilt Assessment Follow-up Teacher Informant
- Fluoride Varnish
ADHD Initial Evaluation
Download Office Policies
New Patient Packet
- Welcome to Kaplan Barron Pediatric Group
- Patient encounter form
- Consent to treat form
- Patient Financial Agreement
- Pediatric Health History Questionnaire
- Well- Visits and Additional Charges
Our office participates with many insurance providers, including:
- Anthem / Blue Cross Blue Shield
- KCHIP (newborns of families that have been our patient only)
- Passport (newborns of families that have been our patients only)
- United Healthcare
If your insurance company is not listed, please call us for further information.