Your Child’s First Visit

We understand your first visit can be overwhelming with paperwork. To help make your check-in easier, we have provided our registration forms online. Links to these printable forms are provided below. Please bring in the completed forms to your child’s visit.

Please read all three pages before the visit.

Privacy Acknowledgment

After reading the Privacy Policy, print and complete this Privacy Acknowledgment Form.

Registration Form

Please print and complete the Registration Form.

VFC Eligibility Screening Form

This form identifies all children who can or cannot receive immunizations through the federal Vaccines for Children (VFC) program. Please print and complete the VFC Eligibility Screening Form.

If you already have a child and are transferring care to Weston Pediatric Physicians, we do require a copy of their medical records from his/her previous practice.

Thank you for choosing Weston Pediatrics to care for your child/children. If there is anything else we can do to assist you, don’t hesitate to contact us.