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972-442-2300  

We are excited that you have chosen Pediatric Associates of Wylie, P.A. for your child's medical care. Your comfort and convenience are our priority, and we strive to make every visit to our office a positive experience.

Patient Forms

For your convenience, our patient forms are located below in our New Patient Packet.  Please print and fill out these forms so we can expedite your first visit:

New Patient Forms:

• New Patient Packet
• 18 Year Old Registration Packet

Release of Information:

•  Authorization for Release of Medical Information to Pediatric Associates of Wylie, P.A.
•  Authorization for Release of Medical Information from Pediatric Associates of Wylie, P.A.

Screening Tools:

• M-CHAT (18 months & 2 years)
• Ages and Stages (9 months)
• Lead Screening (12 months)
• Tuberculosis Screening (12 months)
• School Physical Evaluation (11-18 years)

ADHD:

• Vanderbilt - Teacher Form
• Vanderbilt - Parent Form
• ADHD Packet

             Telemedicine:

• Telemedicine Consent Form

              Influenza (Flu Vaccination): 

• Influenza Vaccination Questionnaire - (Printable)
• Influenza Vaccination Questionnaire - (On-Line)
• Parent Information Form - (Printable)
• Parent Information Form - (On-Line)

In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it.

What to expect

A pleasant, comfortable visit builds trust and helps put your child at ease during future visits. We want your child to enjoy getting to know our doctors and staff, so we work hard to establish this bond during every appointment to our office. From stickers to lollipops, we strive to make our office a fun, comfortable place to visit even when your child is not feeling his/her best.

We look forward to meeting you and your child and providing the quality, comprehensive medical care you expect and deserve.

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