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Pediatric Care P.C. AUTHORIZATION FOR RELEASE OF MEDICAL RECORDS AND×OR INFORMATION TO FROM Pediatric Care P.C. 27790 W. Highway 22, Suite 7 Barrington, Illinois 60010 847 3827337 847 3827377 FAX
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How to fill out pediatric care PC:

01
Begin by gathering all necessary information. This may include the child's name, age, gender, and any pertinent medical history or conditions.
02
Start by filling out the basic demographic information. This typically includes fields for the child's full name, date of birth, address, and contact information for the parents or guardians.
03
Next, provide details about the child's health insurance coverage. This may include the insurance company's name, policy number, and any additional information required for billing purposes.
04
Proceed to document the child's medical history. This can include information about previous illnesses, surgeries, allergies, medications, and any ongoing medical conditions. Be sure to include relevant dates and details for each entry.
05
If applicable, fill out fields related to the child's immunization history. Include dates of vaccinations, types of vaccines administered, and any other relevant details.
06
Document any current medications the child is taking. Include the medication's name, dosage, frequency, and prescribing doctor information.
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Don't forget to include emergency contact information. Provide the names, phone numbers, and relationships of individuals who should be contacted in case of an emergency.
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Finally, review the completed form for accuracy and completeness. Make any necessary corrections or additions before submitting the form.

Who needs pediatric care PC:

01
Infants and young children: Pediatric care PC is essential for infants and young children to monitor their growth and development, ensure timely vaccinations, and address any potential health concerns.
02
Children with chronic illnesses: Pediatric care PC is crucial for children with chronic illnesses, such as asthma, diabetes, or heart conditions. Regular medical check-ups and ongoing care ensure proper management of their health conditions.
03
Children in need of preventive care: Pediatric care PC provides preventive services like routine check-ups, screenings, and vaccinations to keep children healthy and detect any potential issues early on.
04
Parents and guardians: Pediatric care PC assists parents and guardians in understanding their child's health, addressing any concerns or questions they may have, and providing guidance on proper childcare practices.
05
Schools and childcare facilities: Pediatric care PC is often required by schools and childcare facilities to ensure the overall well-being and health of the children in their care. It helps maintain a safe and healthy environment for all children involved.
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