New Patient Registration

We're honored that you have chosen Alabama Pediatrics to care for your family. We ask that you fill out a Patient Registration form, which is PDF Fillable, for each child. You may print it and bring it with you or email it to our clinic before your visit. We require all requested information be provided so we may care for your child properly. Please bring your insurance card and be prepared to pay your copay at the time of service.

We have provided a request for medical records that you will need to give to your last pediatrician to obtain records for our practice. We ask that all new patients please provide a copy of their Immunization record prior to the first visit.

• New Patient Registration Form
• Medical Records Release to Alabama Pediatrics