Patient Fill-out Forms
ESP: Tenemos el Paquete de Paciente Nuevo en español. Para ayudá, que llama a telefono por favor.
Patient Policies
While the summaries provide a general explanation of our policy, it is recommended that you read through the entire document.
No Show Policy Summary:
- We will call to remind you 7 days and 2 days before your scheduled appointment via phone call, text message or email (Please discuss if you’d like to change the method of which you receive messages.)
- 24-Hour notice is needed for appointment cancellation
- Established families can miss 3 appointments within a 365 day period.
- New patients who miss appointments, cancel after 24 hours, or arrive late more than once will not be accepted as a new patient.
- Call during office hours to cancel an appointment
Disruptive Behavior Summary
South Sound Pediatrics will not tolerate:
- Verbal harassment – yelling, threatening or intimidating words or body language
- Demanding, controlling or manipulative statements and requests
- Abusive/offensive language or swearing
- Physical violence or aggression
- Threats of any kind
Violation of this policy could lead to consequences, and at most, discharge from our care.
Divorce Policy Summary
- The parent who is requesting treatment is individually responsible for the payment; we take copay and deductibles from the attending parent.
- Joint Custody: we will not call the other parent for consent prior to treatment/inform the non-present parent of the assessment/plan.
- We reserve the right to charge an administrative fee for copying records should the requests become excessive.
- We are not a party to your divorce agreement. Should issues between the parents become disruptive to our medical practice, we reserve the right to discharge a family from our care and responsibility.