Home
Summit
908-273-1112
Clark
908-273-1112
Summit Pediatrics
.
Menu
About Us
New Patients
Office Info
Insurance
Appointments
Walk-Ins
After Hours
Emergencies
Well Visits
Sick Visits
Prenatal Visits
Expecting?
Hospitals
Get Our Mobile App
Providers
For Parents
Forms
Useful Links
Contact Us
Locations
Forms & Policies
Forms to print and bring to the office
Advocare Child/Dependent Patient Registration
Advocare Assignment of Benefits
Advocare HIPAA Acknowledgement of Privacy Practices
Advocare Consent Disclosure Authorization
Advocare Newborn Insurance Reminder
Patient Medical History Questionnaire
Authorization by Parent or Legal guardian for Another Person to Bring Minor to Physician's Office
Reference forms for your records
New Patient Welcome Letter
Advocare Practice Philosophy
Advocare Payment Policy
Advocare Guide to Understanding Your Statement
Advocare Notice of Privacy Practices
Additional Forms
Records Release Authorization- Joining Advocare Summit Pediatrics
Records Release Authorization- Transferring Practices
18 Year Old Letter and Authorization for Disclosure and Use of Health Information
Mental Health Release of Information
Asthma Action Plan
Asthma Treatment Plan
ADHD
Initial Teacher Vanderbilt Assessment
Initial Parent Vanderbilt Assessment
Initial Parent Vanderbilt Assessment-Spanish
Follow-Up ADHD
Follow-up Teacher Vanderbilt Assessment
Follow-up Parent Vanderbilt Assessment
Follow-Up Parent Vanderbilt Assessment-Spanish
Concussions
Concussion Fact Sheet-English
Concussion Fact Sheet-Spanish
Preventing Concussions-English
Preventing Concussions-Spanish
Developmental Forms
M-CHAT English
Modified Checklist for Autism in Toddlers (M-CHAT)
M-CHAT Spanish
M-CHAT-Portuguese
M-CHAT Italian
M-CHAT French
M-CHAT Chinese
M-CHAT Korean
Food Allergies
Food Allergy Emergency Care Plan
Health Forms
Preparticipation Physical Evaluation
Universal Child Health Record
NYC Child Adolescent Health Examination Form