Olympia Pediatrics, PLLC

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Appointments

Phone: 360-413-8470
Fax:     360-413-8490

Office Hours

Monday-Friday 8am-4pm (temporarily) 

 

Saturday-Urgent Care

(By Appointment Only)

8am-12pm

 

Sunday CLOSED 

 


Articles

KidsDoc Symptom Checker / HealthChildren.org

The American Academy of Pediatrics has introduced a new online tool: KidsDoc Symptom Checker.  This is an online tool that provides parents with information about their children's symptoms and advice on when to consult their medical provider. 


read more...

Forms

Download any of the forms below by clicking on the appropriate title.


  • Appointment Forms
  • |
  • Flu Vaccine Clinic 2020-2021
  • |
  • New Patient Forms
  • |
  • HIPAA
  • |
  • Release Forms
  • |
  • NICHQ Vanderbilt Assessment Forms
  • |
  • Misc.

Appointment Forms

SCARED Long-child version

PHQ-9 & GAD-7

SCARED Long-parent version

SMFQ

PSC-17

SCARED Short-child version

SCARED Short-parent version

ACT-AGE 4-11

ACT- AGE 12 & UP

Flu Vaccine Clinic 2020-2021

Flu Vaccine Consent

Flu Vaccine Information Statement- Mist

Flu Vaccine Information Statement

New Patient Forms

Consent for Treatment of a Minor

Notice of Privacy/HIPAA

Health Questionnaire

Policy Summary

Registration

Aggressive Disruptive Behavior

HIPAA

Privacy Policy

Olympia Pediatrics privacy policy.


HIPAA Acknowledgement Form

This form requires a signature to acknowledge that you have read and understand Olympia Pediatrics HIPPA policy.


Release Forms

Consent for the Treatment of a Minor

Consent for the Release of Medical Records

NICHQ Vanderbilt Assessment Forms

NICHQ Vanderbilt Assessment Follow-up - Parent

NICHQ Vanderbilt Assessment Follow-up - Teacher

NICHQ Vanderbilt Assessment Form - Parent

NICQH Vanderbilt Assessment Form - Teacher

Misc.

Well Child/ Acute flyer

Medication Refill Policy

February Fitness Fun Calendar

Olympia Pediatrics | 3434 12th Ave NE, Olympia, WA 98506 | Ph: 360.413.8470 Fax: 360.413.8490