PATIENT POLICIES

Scheduling Appointments:

• Only two siblings may be scheduled sequentially in order to allow each child enough time to complete his/her examination.
• Well visits after 36 months cannot be scheduled within the same 12-month period.
• If you arrive more than 15 minutes late for your appointment you will be asked to reschedule.
• Patients transferring from another practice may not receive any immunizations until the immunization records are obtained from the previous practice.
   

Referrals:

• Referrals require at least two business days to be completed.  Fracture care referrals are exempt from this policy and will be done within one working business day.
• Referrals will be completed only if the parent provides all necessary information.
• Referrals will only be faxed to a specialist if that specialist does not have Internet access.

Forms:

• Forms require at least two business days to be completed (effective 7/1/08).
• Form PA 586 (Report of Physical/Mental Examination) requires at least three business days to be completed.
• Health forms can only be completed if your child has had a well visit within the last year.
• Patients requiring a sports participation form to be completed must complete or have their parents complete Section 3: Health History of the PIAA CIPPE form.  This form can be downloaded from the Internet at: http://www.piaa.org/assets/web/documents/Section%20VII%20Forms.%20CIPPE_FORM_SECTIONS_1_2_3_AND_4.pdf 

Miscellaneous:

• When leaving a message for a specific doctor, that doctor may not be the one to call you back.
• Medical record and information will only be released to another party if a signed Release of Information form is completed.
• Children with a suspected urinary tract infection (UTI) must be seen for an office visit; providing a urine sample alone is not adequate.
• Children with a confirmed UTI must be seen for an office visit upon/before medication completion; providing a urine sample alone is not adequate.
• All patients receiving immunotherapy in the office will receive a pre-injection assessment of breathing, and must remain in the office for at least 30 minutes after the injection.
• Return to Work/School notes will be completed only if there is documentation of telephone advice given or patient is seen during the illness.

 New Patient Forms (4 pages)  (Microsoft Word)

 Medical Release Form (1 page) (Microsoft Word)