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PAM - Pediatric and Adult Medicine

A member of the CHOC Primary Care Network

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We remain open to provide your child with safe care. Call (714) 565-7960 to make an appointment. Learn more

Patient Forms

You may download and print the forms from this website, fill them out ahead of time, and bring them with you to the first appointment.

To expedite your first appointment, please arrive a few minutes early to complete registration forms so that we have all the necessary information to treat your child. You may also download and print the forms from this website, fill them out ahead of time, and bring them with you to the first appointment.

New Patient Forms, Documents and Policies

  • Patient information sheet
  • Consent for Treatment
  • Pre-visit Questionnaire
  • Welcome letter
  • Vaccine Policy Statement
  • Financial Policy
  • No show – Cancellation Policy
  • After Hours Telephone Calls

General Patient Forms and Policies

  • Certificate of Agreement
  • Over 18 teen consent form
  • CHOC link portal sign up form
  • Tb Risk Factor screening form
  • Preparticipation Sports Form
  • Records Release form

In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it.

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CONTACT

(714) 565-7960
(714) 565-7982 (fax)

MEET

Call to meet our pediatricians
(714) 565-7960

ADDRESS

18102 Irvine Blvd.
Suite 103 and 105
Tustin, CA 92780

OFFICE HOURS

Monday through Friday
7:30 a.m. – 5:30 p.m.

Appointments
8:00 a.m. – 5:15 p.m.

Urgent, Late-Day Appointments
4:45 p.m. – 5:30 p.m.

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COVID-19 Vaccine FAQs: The American Academy of Pediatrics answers parents’ frequently asked questions related to the new COVID-19 vaccines. Read more

ADDRESS

18102 Irvine Blvd.
Suite 103 and 105
Tustin, CA 92780

OFFICE HOURS
Monday through Friday
7:30 a.m. – 5:30 p.m.

Appointments
8:00 a.m. – 5:15 p.m.

Urgent, Late-Day Appointments
4:45 p.m. – 5:30 p.m.
CONTACT
(714) 565-7960
(714) 565-7982 (fax)
  • Our Practice
    • About Us
    • Billing and Insurance
    • FAQs
    • Location
    • Meet the Team
    • Our Providers
    • Services
    • Testimonials
  • Pediatric Health Resources
    • Parenting Articles
    • Coronavirus (COVID-19)
    • Immunizations
  • Pediatric Healthcare
    • After-Hours Care
    • Nurse Advice Line
  • Make Appointment
    • Patient Forms

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