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NEW PATIENTS REGISTRATION - FORMS


 

***WE ARE ACCEPTING NEW PATIENTS***

Welcome to Penguin Pediatrics, we are excited to have you!

We take great pleasure in giving extraordinary care for our patients, as a prerequisite there are certain formalities to be completed to establish patient care at our practice.

New Patients

  • Step - 1: Check your insurance is in our commonly Accepted Insurance List

    (If not found in the list call us to see if we accept your medical insurance)

  • Step - 2: Pre-register to our Online Patient Portal

    (Follow Instructions - Register & Setup Account)

  • Step - 3: Complete the form below and email with all required information to expedite the process as specified in the new patient registration form.

    ALL SECTIONS OF THE FORM ARE MANDATORY FOR NEW PATIENTS

    New Patient Registration Form

  • Step - 4: Expect to receive email with user credential to access Patient Portal.
  • Step - 5: Book Online Appointment on Patient Portal, choose your preferred location and schedule an appointment; upon receiving appointment notification confirm and check-in via patient portal or healow app.

Commonly Accepted Insurances

  • Aetna
  • Freedom Life Insurance
  • Tricare
  • All Savers Insurance
  • Golden Rule Insurance
  • Trust Mark Small Business
  • Anthem BCBS
  • Humana
  • UMR
  • Assurant Health
  • Innovation Health
  • United Healthcare
  • Care First
  • Meritain Health
  • United Healthcare Integrated Services
  • Cigna
  • Oxford Health

Urgent appointment requests can be made by phone at (571) 223-2229

Helpful Instructions

Please Note: Stay connected and on-top of your children's health with our online Patient Portal or Healow mobile app

  • Patient Portal Pre-Registration allows access to the patient and/or legal guardians
  • To schedule online appointments and for a smoother check-in process
  • Complete CHADIS Age-appropriate questionnaires "FILL MILESTONES" before annual well-child visits
  • Request Medication Refills, view Lab Results, and Immunization Records
  • Communicate with Nurse via Patient Portal for quick response
  • Make payments at your convenience from mobile device, or computer securely.

Click to pay your bill via healowPay

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