 |
 |
Forms and Policies
Record Release Authorization
Please use this form to request that a copy of your medical records or your child's medical records are forwarded to the Whole Child Center.
After downloading and completing the form, please send it directly to your child's existing doctor's office, NOT to the Whole Child Center.
If you are joining us as a new patient at the Whole Child Center, welcome! Please take a few minutes to download and complete this form and fax it back to us at 201-634-1606 prior to your first visit if possible. If you cannot fax it to us, please bring it with you to the first visit. Office Policies
For all new patients, you may download our office policies form to review and complete prior to your visit. Please bring it with you to your appointment. HIPAA Information Form
This form describes our privacy policy.
Vaccine Information Statements
We strongly support informed consent with regard to all medical
procedures in our office, including immunization. To review CDC Vaccine
Information Statements listing risks and benefits of particular
vaccines, please visit http://www.immunize.org/vis. We also encourage
you to discuss each and every vaccine with us at your well care visits.
Privacy Policy : Website Design by Networked Politics
