Forms & Policies
Before your appointment with us, quickly and conveniently access patient forms from our practice.
Access Secure Online Patient Forms
Your request will be processed within 24 hours, during normal business hours, Monday – Friday, 8:30am – 5:00pm, excluding holidays. If you do not receive confirmation of your request within 48 hours, please contact our office by phone at 972-747-KIDS (5437).
New Patient Forms
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.
Please Note: New patients coming in for wellness exams must provide shot records at least 48 hours prior to your office visit. Please fax shot records to us at 972-747-5497.
Insurance and Billing
At TLC Pediatrics, PA we are "in-network" with all major HMO/PPO plans. Some insurance plans require a deductible, co-insurance payment, co-payment or other out of pocket expense, which must be paid by the family or patient. Although we verify insurance benefits prior to each office visit, we rely you to become familiar with your insurance policy’s benefits and restrictions. Please bring your insurance card with you to each visit. We consider the individual (family member or not) accompanying the child to the office responsible for the payment at the time of service. Although we verify insurance benefits prior to each office visit, we rely on you to become familiar with your insurance policy’s benefits and restrictions.
Contact us anytime regarding billing questions you may have. Please call us at 972-747-5469 or Contact Us online.
