New Patient Forms

New Patient Forms

Black Hills Pediatrics, LLP

Medical form

New Patient Forms

Our mission is to deliver the best and most comprehensive medical services to you and your family. From newborns to age 18, we strive to serve as your family’s total resource for raising healthy and happy children.


Patient Registration

Privacy Practices Acknowledgment and Patient Consent

Patient Medical History

Vaccine Consent

Personal Relationship Consideration Policy

Absent Parent or Legal Guardian Medical Consent

Failure to Keep Appointment Policy

Notice of Privacy Practices



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