Forms

For your convenience, we have made several forms available for download. This will have you better prepared for your visit and reduce the amount of forms you will have to fill out during your visit. Just click on the links below to download a pdf copy of each form. If you donít have a pdf reader on your computer, please download a free reader here.

In order to become a new patient at Caroline Pediatrics of Greenville, you will need to first have your child's records transferred from your previous practice, using this form:

Authorization for Release of Medical Information

In addition to having your child's records transferred, you will need to fill out a new patient packet before booking the first appointment, this includes first-time parents.

Once completed, you may bring the packet to our office along with your insurance card. You can mail the new patient packet to us ahead of time, but we cannot accept the packet by fax. Physicians require 48-72 hours advance notice to be able to review all new patient medical records prior to being seen in our office.

New Patient Packet

Newborn Care Instructions and Tips

New parents have a lot of questions concerning the care of their newborn. This manual discusses a lot of the most common concerns, including feeding, SIDS prevention, basic infant care, newborn jaundice, bowel movements/urine output, illness, colic, normal findings, and circumcision care are all discussed.

Newborn Care Instructions and Tips

Immunization Schedule

Below is a list of the immunization schedule for birth-6 years old. It includes a detailed breakdown of all the vaccines that your child should receive.

Immunization Schedule

ADHD - Vanderbilt Assessment Scale - PARENT Informant

Below is a resource toolkit for clinicians published by the Academy of American Pediatrics. It provides a number of rating scales and tools for parents that may aid the diagnostic process. The toolkit also provides support information for parents on how to deal with their child at home, help its treatment, and monitor their child's development and long-term outcome. These tools tie in with a resource kit that physicians can supply to teachers to monitor classroom behavior, gain a better insight in the disorder and help their pupil's treatment.

ADHD - Parent

ADHD - Vanderbilt Assessment Scale - TEACHER Informant

The above link is a resource toolkit for clinicians published by the Academy of American Pediatrics. It provides a number of rating scales and tools for teachers that may aid the diagnostic process. The toolkit also provides support information for parents on how to deal with their child at home, help its treatment, and monitor their child's development and long-term outcome. These tools tie in with a resource kit that physicians can supply to parents.

ADHD - Teacher