Forms For new & existing patients

New Patient Forms

Please click on the links below, print out and complete the BOTH the Registration forms AND the New Patient Medical History/Immunization Forms below. Additionally, please bring your current insurance card and a photo ID to your first appointment.

Existing Patient Forms

If this is your first visit in the new calendar year, you have had a change of address or changes to your insurance since your last visit, please complete the packet below and bring it with you to your appointment so that we can update your medical records.

Optional Forms

Associated Brochure Downloads for Your Reference


We accept most major health insurance plans, however it is your responsibility to contact your insurance carrier to verify coverage and benefits. Patients may be held financially responsible for payment of services should the insurance company deny responsibility. Be sure to bring your insurance card with you every time you visit Northside Cherokee Pediatrics. Notify the front desk whenever your insurance coverage changes so that the medical staff can accurately maintain your important medical records.