Patient Questionnaire  and Medical Records Release Forms:

Please download and complete the "Patient Questionnaire" and "Release of Medical Records" forms before first appointment. Bring the completed form with you, or email to [email protected] 

patient-questionnaire-2022.pdf

medical-records-release-form.pdf

Handouts:

COVID-19:

If your child has shortness of breath, difficulty breathing or wheezing, please call the office, or go to urgent care or emergency room. If it’s an emergency and cannot reach us – call 911.

MONKEYPOX

Know the symptoms of monkeypox and when to contact a healthcare professional by going to:  "https://www.cdc.gov/poxvirus/m...". The videos at https://my.officite.com/003864...provide monkeypox recommendations and updates from CDC leadership and partners.

FEDERAL LAWS:

The Families First and Coronavirus Relief Act (“FFCRA”), as amended by the Coronavirus Aid, Relief, and Economic Security (“CARES”) Act, requires commercial health insurance plans,  to cover COVID-19 testing, including administration of the test and related items and services, to i) individuals with signs or symptoms consistent with COVID-19; or ii) asymptomatic individuals with recent known or suspected exposure to SARSCoV-2.

COST: 

If you have insurance, the patient is not supposed to pay for the COVID-19 testing (including cost-sharing, deductibles, copayments, or coinsurance.). We have having difficulties getting your insurance company to pay, and if they pay, they are paying substantially less than what we pay to purchase the 30 Minute Rapid Antigen COVID-19 tests. Therefore, we are required to post our "cash price" - it is $150 for the 30 Minute Rapid Antigen COVID-19 testing, which includes the test, administration of the test and related items and services.  You must first have a telehealth appointment with the doctor to determine if the testing is medically indicated, and the  "cash price" for such telehealth is an additional $125. 

PRECAUTIONS OUR OFFICE IS TAKING: 

We want to reassure our families of the preventative measures that we are taking here in the office:

  • Dr. Weidman and Dr. Beerman have both received their COVID-19 vaccine!!! See his Facebook pay below. 
  • All staff is vaccinated. 
  • No sick children will be in the waiting area. All patients with respiratory symptoms will be placed into rooms immediately upon check in. Most sick visits are being conducted via telemedicine, and if necessary, in the afternoon. 
  • All toys and books have been removed from the waiting area and exam rooms
  • Exam rooms are cleaned thoroughly after each visit and main areas (bathrooms, waiting room, front door) are cleaned multiple times throughout the day.
  • Our office is stocked with personal protective equipment (aka PPE) for our staff. (masks, gloves, gowns, eyeglasses) to protect ourselves from being exposed and to prevent transmission.
  • Everyone in the office - including doctors, staff, parents and patients >2 years old - are required to wear a mask at all times.
  • We will be asking for a credit card number when each appointment is made, as we are trying to limit both the time spent with people at checkout, and the passing back and forth of cards and pens with our front office staff.
  • As a reminder, our office building does have a stairway if you prefer not to take the elevators.

PRODUCT RECALLS:  

Child products, such as cribs and toys are often recalled due to a defect or hazard. It’s important to pay close attention to recalled consumer goods to protect your child from dangerous items. Visit this site frequently to ensure that the products your child is using have not been recalled by their manufacturer or the federal government: Consumer Product Safety

TRAVELING WITH  CHILDREN:

Traveling with children requires special planning and preparation, especially when traveling abroad. There are many things parents should consider when traveling with children of any age.

Visit the CDC’s Traveling with Children page for helpful resources on travel including:

  • Safe food and water precautions, diarrhea management and insect protection when traveling abroad
  • Modifying the immunization schedule
  • Traveling while pregnant
  • Travel and breastfeeding
  • International adoptions