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Patient FormsPatient Forms are in PDF format. Adobe Reader is required. Click here to download Adobe Reader for free here. These forms are available in Spanish upon request at (702) 641-2150. 18-24 Month Developmental Screening (M-CHAT) - English 18-24 Month Developmental Screening (M-CHAT) - Spanish Childhood Autism Spectrum Test (CAST) - English Childhood Autism Spectrum Test (CAST) - Spanish Authorization for Disclosure of PHI Registration Packet – Private Insurance – Newborn-4 Years Registration Packet – Private Insurance – 5 Years and Older Registration Packet - Cash Newborn - 4 Years Registration Packet - Cash 5 Years & Older Registration Packet - Medicaid - Newborn-4 Years Registration Packet - Medicaid - 5 Years and Older Temporary Medical Guardianship HIPAA Notice of Privacy Practices
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Home | Meet Us | Locations | Patient Forms | Insurance | Office Policies
Expecting | New Patients | Child Illness | Affiliations | Medical Library | Helpful Links
EAST 2150 S. Eastern Ave Las Vegas, NV 89104 Phone (702) 641-2150 Fax 702-641-8667 |
WEST 7180 Cascade Valley Court #180 Las Vegas, NV 89128 Phone (702) 641-2150 Fax 702-228-1043 |
Billing/Referrals 2150 S. Eastern Ave Las Vegas, NV 89104 Phone (702) 892-8007 Fax (702) 892-8193 |
Disclaimer: This website has been designed by Desert Pediatrics to provide information of a general nature. It is not intended to be a substitute for the medical advice provided by one's practitioner. Visiting the website DOES NOT establish a patient-physician relationship with any physician or practitioner associated with Desert Pediatrics. If you need information of a specific nature, please contact our office. |
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