Do you need a form filled out for day care, school or camp?

We will complete your forms and guarantee it will be mailed back to you within 2-3 weeks. To speed the process, please complete as much of the form as you can. Also, please let us know if you’d like us to mail the completed form to you or if you would prefer to pick it up.

Below are other medical forms you might need. Please print them and either fax them to us at 952-401-8242 or bring them to your scheduled appointment.

• Consent for Services
• Family Health History Form (Birth-12 months)
• Family Health History Form (12 months-9 years)
• Family Health History Form (10 years and older)
• New Patient Registration Form - All patients being seen for the first time at South Lake Pediatrics must submit a completed registration form. The form must be signed annually by the legal guardian that is financially responsible for your child's care. Also, established patients with any changes must submit a new registration form. 
• Nutrition & Physical Activity Self-Assessment Questionnaire
• Release of Medical Information Consent Form

Opening these files requires Adobe Acrobat. Download it here, for free.