For your convenience, we have made several forms available for download. This will have you better prepared for your visit and reduce the amount of forms you will have to fill out during your visit. Just click on the links below to download a pdf copy of each form.
New Patient Packet
The new patient packet contains all the necessary information for becoming a new patient at Christie Pediatric Group. It includes patient information sheet, billing information, medical record release form, GHS financial policy, consent for treatment, & disclosure of medical information.
DHEC Form (Immunization Form)
A DHEC form (immunization form) should be filled out stating whether your child’s immunizations are covered or not. If you have not filled this out before or you have had a change in insurance, be sure to fill out this form for your next visit. This is a very important and necessary form to have on file for your child.
Authorization for Release of Medical Information
If you need to have your child’s medical records transferred from or to our office, you will need to fill out an authorization for release of medical information.
Authorization for Disclosure of Medical Information
For your convenience, the following forms are also available for download in a Spanish Version: