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
18 MONTH VISIT
24 MONTH VISIT
Or you can print these forms and bring them with you to your appointment.
- Patient Registration
- Insurance Information
- Pediatric Health Questionnaire
- Release of Medical Records to Acton
- Release of Medical Records from Acton
- Vanderbilt from
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.