Forms and Paperwork

All forms such as physical forms, shot records, sports participation forms should be requested at your well child visit. If you have not had a well child visit within the past 12 months, we will be unable to complete your forms without a check-up first. Please call 525-2161 to schedule at the office of your convenience.

Any FMLA (Family Medical Leave Act) paperwork requires a separate visit to complete with the doctor. We will not complete FMLA paperwork without a visit.

If you forgot to request your forms at your last well visit, or are now in need of new or different forms within one year, please notify our office at (727) 525-2161 and allow 48 hours for completion of any forms or paperwork.

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Medication Refills

If you require a refill on your child’s medication, your pharmacy may fax over a refill request to (727) 527-1968. We provide electronic medical prescriptions sent directly to your pharmacy of choice. Otherwise, all refill requests must be requested through our secure patient portal (link). Please provide your email address to our office staff to receive log-on instructions.

In general, antibiotics cannot be refilled without first being seen in office by the doctors.

ADHD medications: ADHD medications must also be requested through our secure patient portal. They cannot, however, be sent electronically and must be picked up in person at one of our offices. Please indicate which office (9th Street, Tyrone or Largo/Seminole) you would like to pick up your prescription. NOTE: All children with ADHD require an appointment for re-evaluation every three months even if no medication changes are anticipated.

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Referrals

Except in cases of emergency, referrals to any specialists require one week’s notice in order for our office to obtain the proper authorization from your insurance carrier. If you need a referral, please contact the office at (727) 525-2161. Please note, most insurance carriers require you to see the primary care physician before going to a specialist.

 

FORMS:

Patient Registration

Consent for Immunizations

Financial policy

HIPAA Policy

HIPPA Consent

History questionnaire