WE ARE NOW ACCEPTING NEW PATIENTS

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    • Home
    • Services
    • Staff
    • FORMS
    • Payments and More
      • FAQS & Info
      • Payment
      • Community
      • Policy
  • Home
  • Services
  • Staff
  • FORMS
  • Payments and More
    • FAQS & Info
    • Payment
    • Community
    • Policy
Great Lakes Pediatric Associates

GENERAL OFFICE FORMS

Feel free to download FORMS and complete prior to your next appointment.  This may decrease your office-wait times.

Authorization_Form_for_patients_18_years_plus (pdf)Download
Consent_to_treat_a_minor (pdf)Download
Health_Appraisal_Form (pdf)Download
Medical_Release_transfer_into_GLPA (pdf)Download
Medical_Release_transfer_out_of_GLPA (pdf)Download
New Patient Packet (pdf)Download
Portal_account_creation_walk_through_by_invitation (pdf)Download
Sports_Physical_form (pdf)Download

HEALTH AND WELLNESS CHECK-UP FORMS

 You can print your forms required and fill-out prior to your visit, by clicking the links below. 


Ages and Stages 2 Month Questionnaire (pdf)

Download

Ages and Stages 4 Month Questionnaire (pdf)

Download

Ages and Stages 6 Month Questionnaire (pdf)

Download

Ages and Stages 9 Month Questionnaire (pdf)

Download

Ages and Stages 12 Month Questionnaire (pdf)

Download

Ages and Stages 14 Month Questionnaire (pdf)

Download

Ages and Stages 18 Month Questionnaire (pdf)

Download

Ages and Stages 24 Month Questionnaire (pdf)

Download

Ages and Stages 30 month (pdf)

Download

Ages and Stages 36 Month Questionnaire (pdf)

Download

Ages and Stages 48 Month Questionnaire (pdf)

Download

Ages and Stages 60 Month Questionnaire (pdf)

Download

Great Lakes Pediatric Associates

3400 Pinetree Rd Suite 102 Lansing, MI 48911

Phone: (517)887-3000

Copyright © 2020 Great Lakes Pediatric Associates - All Rights Reserved.