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

Get Adobe AcrobatTo view the forms listed below, you will need Adobe Reader. You may download Adobe Reader for free at 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 most major HMO/PPO plans. Although we verify insurance benefits prior to each office visit, we rely you to become familiar with your insurance benefits. Please bring your insurance card with you to each visit. Please contact our Patient Accounting Department at (972) 747- 5469 regarding billing or insurance questions you may have.

Contact us anytime regarding billing questions you may have. Please call us at 972-747-5469 or Contact Us online.

for parents

For Parents

Important information about your child's health. [ click here ]

online services

Online Services

Access our secure online patient forms.
[ click here ]