Consent for Non-Parent to Bring Minor Child to Appointment
If you are unable to bring your child to their appointment at Peak Pediatric Care, please complete the form on this page. This will allow you to designate another adult to accompany your child and authorizes them to make medical care decisions.
Medical Release Form
Enter the information for the first child you are registering. You can add additional children in the next step.
Health Insurance Form
Enter the information for the first child you are registering. You can add additional children in the next step.
Sign our Financial Policy
Enter the information for the first child you are registering. You can add additional children in the next step.
Sign up to be notified about our April Peak New Patient Session
Become a Peak Patient!
Enter the information for the first child you are registering. You can add additional children in the next step.