Registration Forms:

Save time at your first appointment by downloading and completing the following forms. You may bring them with you or mail them to the office you'll be visiting.

Click here to download our "New Patient Packet"
Click here to download our "
Initial Visit Medical Information Form"
Click here to download our "
Authorization Release of Records"
Click here to download our "
Privacy Practices" &  "Acknowledgement of Receipt of Privacy Practices"
Click here to download our "
Financial and Billing Policy"

Hospital Affiliations -

Our physicians are on the staff of:

Children's Hospital Oakland
Alta Bates Summit Medical Center in Berkeley
Eden Medical Center in Castro Valley

Insurance Information
here to review Primary Pediatrics' insurance affiliations

Visit our
Locations & Hours
page for more information about making an appointment for your child.


To view the forms listed below, you will need Adobe Reader. You may download Adobe Reader for free at Please bring your completed forms with you to our office at the time of your visit.