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To finish your child's registration, we will need for you to complete the forms listed below. Please print, sign and bring with you on the day of your child's appointment. The forms are in Adobe Acrobat format (.pdf). Please note that we require a valid picture ID from the accompanying adult on the day of your child's office appointment.
The following forms are required for New Patients. These forms also are required for established patients once each calendar year.
 New Patient Registration/Health History Form/Financial
Policy/Privacy Consent/Multiple Insurance Notice
Established patients who have completed the complete registration packet above for the current calendar year need to simply complete the follow up history form to update us each visit on medications, problems and recent illnesses.
Established Patient Followup History Form
If you have a scheduled appointment for the Kids Allergy Center, please download the allergy questionnaire which will be required to assist us in determining which environmental factors may be contributing to your child's symptoms.
Kids Allergy Center Questionnaire
*Adobe Acrobat Reader
In order to print our forms, you need to have Adobe Acrobat Reader installed on your computer. If you do not have Adobe Acrobat Reader on your computer, click the icon below and follow instructions to download. Once this is completed, follow instructions above for printing.
To download your free copy of Adobe Acrobat Reader, please click on the logo below:
Thank you.
Atlanta Kids ENT, PC
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