We gladly welcome your family into our pediatric family!
On this page are several documents you can print out and fill out prior to coming to your first appointment. Our HIPAA policy does not have to be printed, but since you must sign that you have read the policy on the registration forms, it is provided on this page for your convenience.
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Family Registration Form (one per family)
Financial Policy
(one per family)
Family Medical History
(one per child)
New Patients!
Practice Philosophy
Our mission is to provide high professional expertise in comprehensive care to our young patients. We are committed to achieving superior health standards, and developing effective communication skills to assist and educate parents to fulfill their responsibilities to solidify and enhance the family unit according to Godís laws.
Boyd J. Mullholand, M.D.
Consent/Authorization to Treat
(use this form if someone other than the mother or father will bring the child to the office)
HIPAA Privacy Policy
Medical Records Release
(send this form to your previous physician in order for them to release your child's medical records
(one per child)