Administrative Forms Fee

Administrative Forms Fee- Reminder

Over the years the physicians and staff of Peachtree Park Pediatrics have worked diligently to provide excellent care with a personal touch. We have resisted charging fees for extra services and have absorbed the cost of many of these services (e.g. the after hours nurse advice line from Children's HealthCare) for the benefit of our patients and parents. Unfortunately many of the services we provide are not covered by insurance and are extremely time consuming. In 2013 we instituted a nominal fee for the production of medical forms. This includes hearing, vision and immunization forms that are state requirements for daycares and schools as well as forms for specific schools, sports or camps.

We have established an annual records fee of $10 per child with a maximum of $30 per family per calendar year for the completion of forms. This fee will need to be paid prior to completion of the requested forms and will not be billed. This fee is not covered by your insurance company. We will still provide medical records requested by another doctor at no charge to ensure continuity of care.

Forms are completed in the order in which they arrive. Please allow 3 business days for the completion of your forms. Parents should complete all of the demographic and patient history information and sign and date wherever applicable. Forms cannot be completed if the information is incomplete or the child has not had the necessary checkup or tests required. Please indicate with your form how you would like the form returned (self-addressed, stamped envelope, pick up or fax information). If you would like your form expedited there is still a $25 fee for this service.

Please feel free to contact our administrative office if you have questions.