Patient Forms

We are thrilled that you have chosen Acton Road Pediatrics for your children’s health care needs.

If you are an expectant mom we ask that you call us or use the appointment request link on this site after your child is born. Soon after your child is born you will need to get them added to your insurance.

If you are transitioning your care to us from another pediatrician then please call your current pediatrician and request that they fax us all of the pertinent records. Our fax number is (205) 978-8249. Please make sure they include the immunization history, etc. You can also provide them with this secure email address to send records: [email protected] We prefer to see you once we have received those records so as to maximize your first visit with us.

Please make sure that you bring your driver’s license and all insurance cards to your visit so that we can process your claims accordingly.

We are looking forward to meeting you!

You can complete these forms online:

NEW PATIENT FORMS

9 MONTH VISIT

9-mo questionnaire

18 MONTH VISIT

MCHAT

24 MONTH VISIT

MCHAT

MISC FORMS

Or you can print these forms and bring them with you to your appointment.

Parent or patient must complete the front page of the Sports Physical Form

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

Location

Our Location

Find us on the map

Business Hours

We will go back to regular hours when restrictions are lifted.

Monday:

8:00 am-4:00 pm

Tuesday:

8:00 am-4:00 pm

Wednesday:

8:00 am-4:00 pm

Thursday:

8:00 am-4:00 pm

Friday:

8:00 am-4:00 pm

Saturday:

Closed

Sunday:

Closed

Testimonials

"“Very satisfied with the care my child receives with Dr. McAfee. We’ve been seeing Dr. McAfee for years. She is like a trusted friend. Highly recommend Acton Road Pediatrics.”"

Lisa/Pleasant Grove
"“Nothing worse than getting a call that your child is sick. But being able to call Acton Road Pediatrics and get them seen that day makes all the difference. Dr. Breedlove was so kind and accommodating. She put me at ease and took good care of my daughter.”"

Jasmine/Leeds
"“I can’t imagine anyone but Dr. Moore as our pediatrician. We recently moved to the Birmingham area and heard a lot about Acton Road Pediatrics. Happy to say that all of the recommendations were spot on. Friendly staff, efficient processes, respectful of our time. Just a great experience all the way around.”"

Anna/Hoover
"“We love Dr. Frees and her entire staff. She is down to earth and has a great bedside manner. They are like an extended family. Thanks to everyone for taking such great care of my children.”"

Heather/Birmingham
"“Dr. Breedlove is amazing! She is great with her patients and spends as much time as needed with you to get all questions answered and also just to get to know you. You’re not just a number to her! You can tell she truly cares about her patients! I would recommend her to anyone!”"

Francine/Pelham
"“Dr. McAfee and her staff are amazing and I even switched my daughter from her pediatrician to be seen by Dr. McAfee exclusively. She takes care and remembers you every single time. I wouldn’t trust anyone else with the care of our family.”"

Cameron/Bluff Park
"“I’ll keep this simple. Dr. Moore is the best pediatrician by a long shot. I recently transferred my son’s care to her. The office staff is so friendly! I always leave feeling so much better in every way. I’ll never use anyone else for my son. If you need a great pediatrician to help you with your kid’s health and wellness do yourself a favor and meet this doctor!”"

Lydia/Mountain Brook
"“My twins had their first visit with Dr. Breedlove and it was a delight. She immediately made me feel very comfortable and it felt as if she had been their doctor for years. I am very happy to have found a pediatrician that I feel I can trust with the care of my children.”"

Monica/Hoover
"“Great experience! My daughter got sick at school and I was able to make a same day appointment with Acton Road Pediatrics and got in right away. The front desk staff and the medical assistant were very nice and helpful. Dr. Frees was great, gave realistic expectations and timelines. I’m so glad that we chose Dr. Frees as our pediatrician.”"

Eleanor/Chelsea
"“Dr. McAfee is a great doctor! She’s very understanding and listens to your concerns. She takes time with my son to help him with his health issues! I highly recommend her to anyone looking for a pediatrician.”"

Julie/Bessemer
"“As a first time parent I was really nervous. The staff and Dr. Breedlove were all very friendly and helpful. I especially loved how Dr. Breedlove really took her time to explain everything with us. The visit was great and the doctor’s demeanor has really put my husband and me at ease. I’ve told my New Mom group all about Acton Road Pediatrics!!”"

Payton/Gardendale
""Great medical office, wonderful, warm experience from start to finish. Appreciate Dr. Moore taking time to go over the diagnosis clearly and treatment options. Many thanks to everyone at Acton Road Pediatrics.""

Angela/Birmingham
"“Dr. Frees is incredible. Not only has she taken great care of my children, but also she is lovely to speak with at every appointment. It’s rare to find a doctor that combines such personal touches and care for a patient as a person with outstanding quality of medical care. I highly recommend Dr. Frees!”"

Janet/Vestavia