Patient Info

New Patient Info & Forms

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At Commonwealth Pediatrics, our goal is to provide your child with expert, compassionate care. We want to make sure that your child feels as safe and comfortable as possible in our office. Our practice will work with you and your child to give your child the best possible care tailored to their needs. We will also make sure that the parents of our patients feel knowledgeable and comfortable raising and taking care of their child. After all, your child’s health is our highest priority!

If you’re ready to schedule an appointment with us, fill out our online appointment request form or call one of our office locations. Please note that we must have the medical records for new patients before scheduling an appointment.

Your First Visit With Us

During your child’s first visit with us, we will first review their medical and health history. After examining your child, we will make sure to address any questions or concerns you may have, and discuss best practices for nutrition, exercise, child safety and more. Our priority is your child’s health and wellness. We will work with you and your child every step of the way in order to make sure your child is receiving the best care possible, and that you, as a parent, feel comfortable helping your child grow.

Patient Forms

For your convenience, we have provided our new patient forms on our website. To save time during check-in, we invite you to fill out our new patient forms below ahead of your first visit.

We also offer a variety of other medical forms online, including an allergy questionnaire, asthma questionnaire, flu screening, FLMA request form and more. If you have any questions about these forms or are having difficulty accessing them, please contact our office.

We look forward to caring for your family!

Insurance And Finances

It is recommended that you have insurance coverage for your child’s medical care. At Commonwealth Pediatrics, our compassionate team will try to do everything in our power to ensure you get the most out of your insurance coverage, including filing claims. If you have any questions about your policy, please contact your insurance provider.

Please be sure to bring your child’s insurance card with you to each appointment. If your insurance coverage changes, please notify our team as soon as possible. Co-payments and balances are due at the time of service.

We currently participate in the following insurance plans:

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Medical Records

Your child’s medical record is housed in our electronic management system, which enables your child to be seen at our Harbour Point, Old Jahnke Road or Westchester Commons office.

A Release for Medical Record Transfer Form must be completed in order to have your child’s medical record copied and forwarded to another physician. This form may be completed at either office or printed from this page. If you download from this site, you can either fax or mail the form to our office. We require two weeks to copy and forward your chart to the new physician.

We are happy to supply you with a copy of your child’s immunization record and last physical exam free of charge. All other copying of charts is subject to our charges for Medical Records.

If you have transferred to another practice or have not been seen at our office in over three years, your child’s chart is transferred to our storage area. The complete original chart will be kept in storage until the time that your child reaches twenty-five years of age. If your child’s record has been forwarded to our storage area, it may take several additional days to have copies or forms completed.

Virginia law requires that licensed daycare providers and schools maintain current medical information on all children attending their facility. These are typically known as the state school forms. Other organizations, such as camps, sport clubs and school teams, may require certain paperwork be completed prior to your child’s participation. Please be aware that we require two to three business days (depending on volume) to complete all forms of this type.

Also, check the form carefully to determine the requirement for the child’s last physical exam. Many of the school sports teams require that the child’s physical exam is done between the months of May and August. Likewise, the Virginia State Form requires that the child have had a check-up within the past twelve months. If your child does not meet the specific form requirements, you will need to make an appointment to complete all necessary screenings or vaccinations prior to our completing the form.

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Ready For Quality Pediatric Care?

High-quality pediatric services are just a click away! The Commonwealth Pediatrics team is dedicated to providing families with compassionate, patient-focused care you can trust. We put our patients first, and that starts before you ever set foot in our office. If you’re ready to schedule an appointment with us, fill out our online appointment request form.