If this will be your child's first visit with our doctors, please use the following link to download our new patient forms package. Print the forms then bring the completed forms with you to your first appointment. Also please be prepared to pay any deductibles or coinsurance due at time of visit.
- Click here for the new patient's forms package in English.
- Click here for the new patient's forms package in Spanish.
- Click here for the "Release of Medical Information" form.
- Click here for the "Notice of Privacy Practices" form.
NOTE: Adobe Acrobat® reader is required to view and print these forms. If you do not already have Adobe Acrobat® reader installed, you can download it here.
Please help us stay on schedule by arriving at your child's appointed time. Should you need to be seen immediately, contact our scheduling department and they will schedule your child for the earliest available time. Please do not bring your child without calling first; our physicians must work by appointment. Because we are a specialty practice, it is not uncommon for wait times to be lengthy and vary depending on each particular doctor's schedule. Please plan your appointments accordingly.
Because our reception area is small, we request that you limit the number of friends and family members you bring to your child's appointment. This will ensure adequate seating for children who are not feeling well. Please notify the receptionist on arrival if your child may be infectious or requires special care.
If for some reason you are unable to keep your scheduled appointment, please notify us as far in advance as possible. Appointments not cancelled within 24 hours of the scheduled appointment time will be subject to a $50 no-show charge.
Children's Center for Digestive Health Care provides continuous coverage for emergencies. The on call physician can be reached 24 hours a day at (404)257-0799. If we are not in the office leave a message with our answering service. Please state the child's name, age, problem, and your phone number. If you do not receive a return call within a reasonable time, please call again. In the event of a serious emergency, take your child to the nearest emergency room, leaving a message with our service. The emergency physician can call our doctor for consultation.
Fees and Payment
In order to keep costs down, we ask that you pay your copay at time of service. If we must bill you for your copay, a $20 service fee will be applied. As a service to our patients, we will assist you in filing your insurance forms for hospital services. We will be glad to discuss our fees with you at any time and give you a cost estimate in advance of your visit or lab tests. If our fees impose a financial burden, we will try to work out a payment plan. If there is a problem, please contact our account manager to make specific arrangements for payment. For your convenience, you may use Visa or Mastercard.