Forms

Resources

To facilitate a smoother and more efficient visit for you and your child, we have implemented the Phreesia check-in process. You can complete most forms and check in from the comfort of your home, on your phone, or using the Phreesia Pad in our office. If you have questions or concerns about your upcoming appointment, please contact us here.


Fees:

     • Letters - A fee of $25.00 will be charged for each official letter provided by our physician and/or provider of service. (For example a diagnosis letter and/or similar letters.)
     • Forms - A fee will be charged for each additional official form completed by our physician and/or provider. This includes FMLA, SSI, SCHOOL HEALTH, DISABILITY FORMS, DEPT OF MOTOR VEHICLES and similar forms. The Fee will be $25.00 for a one-page form and $35.00 for a multiple page form.

     • Records - The fee for copies of medical records is $1.00 per page up to 25 pages. Each additional page will be $.25 cents as provided/allowed by the state law. Copy of CD's from EEG studies is $25.00 per study day.


You must have Adobe Reader® installed in order to view the forms. If you do not have Adobe Reader®, you can download it here for free.

Your Child's First Appointment

 

Parents, please note that due to the I-4 construction, traffic is always an issue in and around Orlando. Please plan accordingly to arrive thirty (30) minutes before your scheduled appointment in order to complete your registration paperwork, pay any copays, and complete the check-in process.


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Copyright © 2009 - 2013. Florida Child Neurology, PLLC
A Division of Florida Pediatric Associates, LLC. All Rights Reserved

Telephone: (407) 897-3544

Toll-free: 866-356-3075

Fax: (407) 897-4016