Patient Forms

Suburban Pediatrics welcomes new patients. Choosing the right pediatrician for your child is one of the most important decisions you will make. By selecting Suburban Pediatrics, you can feel confident and comfortable that you have made the right decision.

To understand what to expect for your child's first visit to our practice, please read through this page.

Our Mission

Suburban Pediatrics is a well-established, physician-owned pediatric practice with offices in West and South County St. Louis.  Our practice is comprised of seven doctors, three pediatric nurse practitioners, and thirty nursing and administrative staff members who share a common goal of providing the highest quality pediatric care in a compassionate, professional atmosphere.

New Patient Forms

To expedite your first appointment, please arrive a few minutes early to complete registration forms so that we have all the necessary information to treat your child. You may also download and print the forms from this website, fill them out ahead of time, and bring them with you to the first appointment.

Patient Registration Form

Financial Policy Form

HIPAA Policy

Medical Record Transfer Form

Other Patient Forms

Missouri MSHSAA Form

Illinois IHSA Form

Vanderbilt Parent Form (for initial evaluation and med check visits)

Vanderbilt Teacher Form

Vanderbilt Teacher Followup (for one month medication check)

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

We look forward to meeting you and your child and providing the quality, comprehensive medical care you expect and deserve.

Our Location

Find us on the map

456 N. New Ballas Rd., Ste. 304
St. Louis, MO 63141
4116 Von Talge Rd., Ste. B
St. Louis, MO 63128

Questions or Comments? We encourage you to contact us whenever you have an interest about our services.