Below is information and a number of forms designed to make your visits at Pinwheel Pediatrics more productive and informative. Filling out many of these forms and forwarding them to us in advance can save you a great deal of time. You may email them to info@pinwheelpediatrics.com

INSURANCE

Health care insurance is intended to cover some, but not all of the cost of your medical treatment. Please familiarize yourself with your specific policy by contacting your benefits office or by calling the phone number listed on your insurance identification card. You should be aware of any deductibles, coinsurance, and co-payments, as well as non-covered services.

Pinwheel Pediatrics currently participates with the following insurance plans:

• Aetna US Healthcare HMO, PPO, and POS
• Anthem Blue Cross & Blue Shield PPO and HMO
• Cigna PPO and HMO
• Pacific Care PPO and HMO
• United Health Care HMO, PPO,POS
• PHCS PPO (Private Health Care Systems)
• Great West PPO and HMO
• First Health PPO and HMO

NEW PATIENTS

In order to make your visit at Pinwheel Pediatrics more informative and efficient, we have made the below form available for you to download in advance of your visit with us. Please complete the registration form and the appropriate medical history form for your child's age and bring it to your appointment. Our friendly registration staff will take it from there. Also bring a copy of your child's vaccine records in addition to any other medical records you think the doctor should see. The forms below are PDF.

Download Registration Form

MEDICAL HISTORY FORMS

Download Infants and Children Up to 5 Years of Age

Download Children from 6 Years Old to 12 Years Old

Download Adolescents 13 Years and Older

NEWBORNS

Inevitably bringing home a newborn is a bit scary and we hope to ease that fear by anticipating the questions you will confront as you care for your child in his or her first days. The booklet below coupled with frequent meetings with your pediatrician will guide you through these exciting days! Think of it as an owner's manual, a how-to book.

Download NEWBORN Booklet

VACCINATIONS

Pinwheel Pediatrics remains dedicated to preserving the health of children and adolescents. One of the most important steps in achieving this goal is immunizations. A great deal of information about vaccines is scattered across the news and the internet; much of it is inaccurate. We encourage you to bring your questions and concerns to your appointments and discuss them with our staff. Below you will find useful information concerning individual vaccines and the recommended schedule.

• Vaccination Schedule - Recommended by the American Academy of Pediatrics and the Advisory Committee on Immunization Practices. Click here

• Booklet on Vaccinations - A short book designed specifically for parents explaining the need for vaccinations and descriptions and possible side effects of individual vaccines. Click here

• Common Side Effects - The most common side effects of vaccines include fever, irritability, and swelling & redness at the site of the vaccine. For more information concerning these common side effects, click here.
For Tylenol® dosing you may click here.

• Thimerosal - Today, with the exception of some flu vaccines, thimersol is no longer used as a preservative in any vaccines. The vast majority of studies involving hundreds of thousands of children in many countries, have found no association between thimerosal used in vaccines and autism.
For more information click here Mercury and Thirmerosal

VACCINE INFO SHEETS

• Chickenpox (varicella)

• DTaP

• Flu

• Hepatitis A

• Hepatitis B

• Hemophilus Influenza B

• Human Papilloma Virus (Gardasil)

• Meningococcal

• MMR

• Prevnar

• Polio

• Rota Virus

• Tetanus Booster

MEDICAL RECORDS

Medical records can be obtained from our office within 7-10 days of a signed written consent. Any patient who is over the age of 18 must sign for the release of their own medical records. There is a fee of $20 per chart for copying records. These requests are best made via fax as they require a signed statement allowing for release of these records. Please fax them to (925) 827-9278.

Download Medical Records Release Form

CAMP & SCHOOL FORMS

To have camp, school, and other forms completed there is a fee of $10. Your child must also have had a physical examination within 1 year of completion of the form or as current as required by the form. Requests for completion of camp forms and school forms may be made via fax or email.

AFTER HOURS

We all know that, chances are, when your child gets sick, it isn't going to be during regular office hours. Pinwheel Pediatrics participates in an after hours clinic, a full-service clinic and call center operated by the Pediatric Referral Group (PRG). The clinic is
located in Walnut Creek, close to John Muir Hospital and is staffed by a pediatrician, registered nurses and medical assistants. By calling PRG clinic you can get phone advice with specific treatment options for any urgent care problems your child may develop. Whether your issue was resolved over the phone, or your child was seen by a doctor, all of your interactions with PRG staff will be documented and faxed to your child's pediatrician, so that in the morning, she has the necessary documentation to follow up with the needs of your child and maintain continuity of care.

Pediatric Referral Group
1479 Ygnacio Valley Road
Suite 208
Walnut Creek, CA 94598
Advice Line 925.930.6295