Welcome to the Wyckoff Pediatrics Patient Information Center
For new patients there is information about our practice which can be printed out and brought with you at your first visit.
For our established patients there are copies of forms for a variety of situations including school physicals. Preprinting some of these may be helpful. Bear in mind that we give you a copy of your childs Universal Child Health Care Record or part B of the Athletic Pre-Participation Physical Examination Form which have been preprinted with much of your information, at every physical exam.
My Kid’s Chart
My Kid’s Chart is our new Pediatric Patient Portal tool. Once you register for the Portal you will have access to a lot of information about your child.
Immunizations, school and camp forms, and more will be available for you to download at home at your convenience. Additional information may be accessed upon request.
There is a secure messaging feature which will allow you to send non-urgent messages to the office and doctors as well. Messages will be check frequently and in most cases replies will be given within 2 business days. In addition files such as forms and pictures may be uploaded to us a well
We value our patient’s privacy. Access to patient information is turned off on the 18th birthday. Of course, those patients may register for their own accounts as well. In addition, they may authorize their parents to have access to their records by filling out a Parental Authorization Form.
Download the My Kid’s Chart Users Manual
Information for New and Prospective Patients is outlined below.
- Practice Brochure
- HIPAA Privacy Notice
- Your Health Plan Coverage and Our Financial Policies
- BCD Financial Policies Page
Prior to your first visit, we would like you to complete new patient forms so that we may obtain all previous records you or your child may have.
Please print out and complete these forms prior to arrival. The new patient packet includes the following information:
- Family Information Sheet
- Insurance Information Form
- Financial Policy Acknowledgement Form and Waiver **
- HIPAA Policy Acknowledgement Form
** Please do not sign this form until you have read all the sections of the Financial Policy above.
- Universal Child Health Care Record
Provided for Grades K through 5.
- Athletic Pre-Participation Physical Examination Form
Please print out this form and complete the History (Page 1, complete page 2 for children with disabilities) before you bring your child for a physical exam. (6th grade and older). Pages 3 and 4 will be provided.
- New York Health Certificate and Appraisal Form
Most NYS schools accept the NJ form, but you may bring this if yours does not. Please prefill demographic information.