FORMS

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FORMS

Whether new to our office or new to parenting altogether, we welcome you to the Rainbow Kids Clinic Family!

Our professional team provides quality care that your child needs and the advice and counsel you want.

All healthy children will be assigned to a nurse practitioner to provide continuity of care. You will be assigned to a doctor if your child has complex medical issues, such as cerebral palsy, or extreme prematurity, etc.

We at Rainbow Kids Clinic believe that your child should see the same provider each visit because your child needs someone who is familiar with him or her and knows you on a personal yet professional level.

We know that at times you may have particular concerns or a sick child when you want to see a physician, we assure you at these times a physician will be there for you and your child.

Registration for new patients less than 1 month old

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FILL OUT ONLINE FORM PRINT FORM FORMS IN SPANISH
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Registration for new patients more than 1 month old

Smiling preteen
FILL OUT ONLINE FORM PRINT FORM FORMS IN SPANISH
HIPPA compliant logo
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If you have any questions, please contact MediCopy:

Online chat: MediCopy.net


We have partnered with MediCopy to fulfill your Release of Information requests. MediCopy is fully HIPAA compliant and adheres to all state and federal regulations concerning release of medical information.

We have partnered with MediCopy to fulfill your Release of Information requests. MediCopy is fully HIPAA compliant and adheres to all state and federal regulations concerning release of medical information.

Medical Records

Patients can request copies of their medical records at no cost, but delivery fees apply for postage, so provide an email address! Please provide an email address on the authorization to expedite the process and delivery method. Records sent via email or to another provider are complimentary. Requests are completed within two (2) business days after receipt by MediCopy.

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