Parents Page

New Patient Forms

Please download, review, and complete (if necessary) the forms available below.
New Patient Packet
New Patient Packet Spanish
Consent for Another Adult to Bring Child

Release of Records and Info

Records Release Form
Records Release Form Spanish
Info Exchange Authorization Form

Vaccine Policy

Vaccine Policy

No-Show Policies

Please review our new policies related to no-show appointments.
Current Patient No-Show Policy
New Patient No-Show Policy

Other Resources

Speech and Language Screening Waupun School District

Helpful Links

AAP Pediatric Patient Education
Pediatric patient education materials

American Academy of Pediatrics
Dedicated to the health and well-being of infants, children, adolescents and young adults.

Family Voices
A statewide network of families who have children and youth with special health care needs and/or disabilities.

A 501(c)(3) non-profit organization providing comprehensive programs and services that enhance the quality of life for children and adults with disabilities and their families.

A 501(c)(3) non-profit organization providing education, advocacy and support for individuals with ADHD.

Children's Health Alliance of Wisconsin
A Wisconsin based organization that raises awareness on important issues related to children's health. They work with leaders to create policy, and impact public health by implementing programs that are proven to work.

Reach Out and Read
A nonprofit organization that gives young children a foundation for success by incorporating books into pediatric care and encouraging families to read aloud together.