Use this page to find the forms and information your family may need before a pediatric visit with Sylacauga Pediatrics or Summit Pediatrics.
The right form depends on the visit. If you are not sure what to complete, choose your office or call the location your family uses.
Choose the option that best matches what you need. Each page gives you the next step for your child’s visit, records or paperwork.
For families starting care with Sylacauga Pediatrics or Summit Pediatrics.
For requesting, sending or transferring your child’s medical records.
For physicals and documentation related to school, activities and athletics.
For insurance information, billing questions and what to bring to a visit.
For refill requests and medication-related office guidance.
If your office asked you to complete a specific form, call the location your family uses if you do not see it here.
Having the right information with you can make check-in and the visit itself easier. Bring anything your office specifically asked you to complete or provide.
Start with the form or paperwork your visit requires, then keep a copy for your records when appropriate.
Start with Sylacauga, Chelsea or Valleydale Road based on what is most convenient for your family.
Ask whether the office is currently scheduling new patients and what appointment options are available.
Review patient forms and ask whether prior medical or immunization records are needed before the visit.
If you were asked to complete a specific form and do not see it here, call Sylacauga, Chelsea or Valleydale Road for the right next step.
115 West Clay Street
Sylacauga, Alabama 35150
134 Foothills Parkway
Chelsea, Alabama 35043
1200 Providence Park, Suite 100
Birmingham, Alabama 35242
The forms you need depend on the type of visit. Follow any instructions from your office and call if you are unsure what to complete.
New families should bring the forms and records requested by the office, along with insurance information when applicable and any other information requested for the first visit.
Use the Medical Records page for information about requesting, sending or transferring your child’s records.
Use the School, Daycare, Sports & College Physicals page for visit and documentation information related to school or activities.
Call the pediatric office your family uses. The office team can help you identify the right form or next step.
For office-specific paperwork questions, contact Sylacauga, Chelsea or Valleydale Road directly.
Choose your pediatric office for help with forms, records or visit preparation.
Providing compassionate comprehensive pediatric care for infants, children, and adolescents at three convenient locations in Alabama.
115 West Clay Street
Sylacauaga, Alabama 35150
Mon, Tue, Thu: 8:00AM – 5:00pm
Wed: 9:00am – 4:00pm
Fri: 9:00am – 12:00pm
Mon – Fri: 8:00am – 5:00pm
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