Forms | THR Pedatrics & Wellness Center

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THR Pediatrics & Wellness Center

New Patient Forms

Please use the following links to access our new patient forms.

Patient Registration Form

Medical Health Form

Patient Health History Form

Authorize to Accompany Child Form

Vaccine Policy Statement

Notice of Privacy Practices

Privacy and Payment Acknowledgement Form

Payment Policy Form

Once completed, please email forms to thrpedsrichards@outlook.com

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