New Patient FormsCOVID-19
SafetyAppointment PoliciesAfter-Hours
CareVaccines & Antibiotics

New Patient Forms

Complete your new patient paperwork online using our convenient and secure forms. Please select the list of forms that applies to you, and complete each form in the list unless instructed otherwise.

New Baby

  • If you are preparing for a meet and greet, you only need to complete the first form in this list. Otherwise, please complete all forms.
  • New Baby Registration Forms
  • Notice of Privacy PracticesThis document describes how medical information about you may be used and disclosed. Please review it carefully.

New Patient Transfer

Sick Visit (Non-Patient)

COVID-19 Safety Procedures and Testing

Safety First

Appleseed Pediatrics takes the safety of our patients and staff very seriously. All adults and children over 2 years must wear a mask inside for any sick symptoms.  All of the providers and staff are vaccinated against COVID-19.

We are adapting our office procedures as needed during the COVID-19 pandemic. Please read the details below before your next visit.

Scheduling

We work very hard to keep sick and well patients separate. We do this by having separate entryways and exam rooms for sick and well patients. 

For any scheduled well child visits we ask you to call us and reschedule your appointment if:

  • Your child has had a direct COVID exposure in the past 10 days.
  • Your child or the parent/guardian bringing them is COVID positive.
  • They have any of the following symptoms including but not limited to: fever, cough, congestion runny nose. We may need to change your child’s appointment from a well to sick appointment.

If your child is scheduled for a sick visit, call us when you arrive and we will bring you right into a room through our sick entrance. If a caregiver is COVID positive, we ask that the child be brought in by another healthy adult. 

Please do not bring siblings to visits unless there is absolutely no alternative. 

Personal Protective Gear and Cleaning

We require that all adults and children over the age of 2 years wear a mask in our office at all times. This includes wearing a mask in the exam room. If you or your child do not have a mask we will gladly provide you with one. 

We follow the CDC guidelines for cleaning our rooms and office, including door knobs, light switches, and equipment. 

COVID Testing

We proudly offer rapid COVID PCR testing in our office The test is done with a swab that is placed in the front of the nose.  Our results are back in 50 minutes.

We also offer combination testing that includes COVID and other viruses like the flu and RSV.  Ask us about it. 

Appointment Policies

  • All visits, including COVID testing and vaccinations, require a scheduled appointment.
  • If more than one child needs to be seen, please schedule an appointment for each child.

Missed Appointments

We ask that you notify the office as soon as possible if you are unable to keep an appointment. We require notice of at least 1 business day for all cancellations, as it allows the time to be used to meet the needs of other patients.

Missed appointments hinder your child’s health care as well as others.  Failure to notify the clinic in a timely manner will result in a no show fee of $25. Repeated no-shows will result in the family being advised to transfer care out of the practice.

Late Arrivals

As everyone’s time is valuable, we kindly ask that you make every effort to arrive on time for your scheduled appointment.  If you are running behind we ask you to call us.  If you will be more than 15 minutes late we reserve the right to reschedule your appointment to a later time or another day. 

After-Hours Care

If your child’s illness or injury is life-threatening, call 911.

If you have an urgent matter that truly cannot wait until regular office hours, please call our office and the answering service will connect you with our triage nurse or our emergency on-call provider.

We aim to keep you out of the emergency department and most urgent issues can be expertly managed by our triage nurse or one of our providers. We do ask that you are respectful of our time when the office is closed and only call us if it is a true emergency.

If you don’t hear from us in an hour, please us call back. Messages are sometimes relayed incorrectly. Do not leave any urgent messages on our voice mail as they are not listened to until the next business day.

For routine matters such as scheduling an appointment or a refill, we kindly ask that you call us during regular business hours.

Emergencies

Because emergencies are unavoidable, here is a list of recommended places for emergency or urgent care:

We Are a Vaccinating Practice

Immunizations are one of the modern success stories of medicine. We cannot over-emphasize the importance of vaccinating your child against preventable diseases according to the well-studied CDC schedule of immunizations. Appleseed Pediatrics requires that all patients follow this recommended schedule except in the rare instance there is a medical contraindication to immunizations. These will be considered on a case by case basis, discussed directly with your provider.

Vaccinations keep our patients, their families, our other patients (especially those who cannot be vaccinated for medical reasons) and the community safe. If after a thorough discussion of the risks and benefits of vaccination the care giver still chooses not to vaccinate for personal, religious or philosophical reasons, they will most likely be asked to find another practice.

Antibiotics Must Be Used Responsibly

We strongly believe in the responsible use of antibiotics, and make every effort to prescribe them only when a bacterial infection is suspected. Antibiotics have no benefit against viral infections, and can cause unintended side effects, especially when used inappropriately or excessively. We also do not routinely prescribe antibiotics over the phone.

Vaccine Schedule

  • NewbornHepatitis B #1 (if not given at the hospital)
  • 2 monthsPentacel #1 (DTaP, IPV, HIB), Hepatitis B #2, Prevnar #1, Rotarix #1
  • 4 monthsPentacel #2 (DTaP, IPV, HIB), Prevnar #2, Rotarix #2
  • 6 monthsPentacel #3 (DTaP, IPV, HIB), Hepatitis B #3, Prevnar #3
  • 12 monthsMMR #1, Varicella #1, Hepatitis A #1
  • 15 monthsPentacel #4, Prevnar #4
  • 18 monthsHepatitis A #2
  • 4 yearsProquad (MMR/Varicella), Kinrix (DTaP and IPV)
  • 11 yearsTdap, MCV, HPV If HPV is given before 15 years two doses required, after age 15 three doses required.
  • 16 yearsMCV (Meningococcal vaccination)
  • FluStarting at age 6 months. Those children getting their first dose of flu through age 8 need two doses one month apart otherwise it's once a year.
  • BexeroHighly recommended at age 16 for adolescents at highest risk for meningitis like those living planning to dorm at college or join the military.
  • COVIDFrom 6 months to 5 years old

Vaccine Resources