Thank you for choosing Biskup & Segui Pediatric Partners, P.C. as your child's medical home, where we always provide a comfortable, caring environment so our patients and their families can feel at ease. We've included helpful items on this page to ensure you and your child's first trip to our office is productive, stress-free and enjoyable.
Our practice is working together to build life-long relationships between our staff and our patients by consistently providing our patients with compassion, excellence and value. To fulfill this mission, we are committed to:
- Improving the lives of the children we serve by providing quality care in a child-centered environment.
- Listening to our young patients and their families who we are privileged to serve.
- Guiding our patients along a path of optimal health and wellness.
- Continually pursuing excellence at all levels through continuing education.
If you're preparing for your child's first visit, you can do a few things to help expedite the appointment. Please provide the following information when you arrive for your visit:
- Insurance cards
- Complete immunization records
- Medical records from your previous pediatrician
- Parent driver's license
- New Patient Packet (see patient forms below)
We are happy to provide our office forms for convenient download on your home computer. Please print and complete the New Patient Packet and bring the completed forms with you to your child's first appointment. We have also provided other miscellaneous office forms. If you have questions on what other forms may be needed for your child's visit, please don't hesitate to call our office.
New Patient Packet:
- Patient Registration Form
- Patient Registration Form 18 And Older
- Office Financial Policy
- Medical Release Form To US
- Consent for HIPPA
- Consent to Treat Minor
- Electronic Health Exchange Release
- Notice of Privacy Practices
Other Office Forms:
- Lead Risk Questionnaire
- Medical Release Form From Us
- PHQ9 Depression Screening
- Pediatric Symptom Checklist
- Postpartum Depression Screening
- SCARED Anxiety Screening Parent
- SCARED Anxiety Screening Child
- Tb Risk Questionnaire
- Youth Pediatric Symptom Checklist
In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it.
The Initial Visit
Our compassionate and knowledgeable pediatricians do whatever it takes to make every visit to our office a pleasant, relaxed experience. With all of the important information about our practice available on our website, you can feel confident that you and child are well-prepared for your first appointment. We also invite you to review our About Us page in order to get to know our doctors. We look forward to meeting you.