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Dekalb Pediatric Center Jane Wilson, MD, Debby Pollack, MD, Michael Levinthal, MD, Melinda Shelton, MD, Rebecca Roles, MD, Peggy Marcus, MD, Mary Abraham, MD & Lesley Cog burn, RN, PNP 350 Win Way
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Begin by visiting the Dekalb Pediatric Center's website or office to access the necessary forms.
02
Obtain the patient's medical records, including any immunization records, previous diagnoses, and medications.
03
Fill out the patient information section of the form, providing accurate details such as name, date of birth, and contact information.
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Include the primary care physician's contact information and any relevant insurance details.
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Fill out the medical history section, providing details about current and past medical conditions, allergies, and surgeries.
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Indicate any ongoing medications or treatments in the appropriate section.
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If applicable, provide information about any emergency contacts and their relationship to the patient.
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Review the filled-out form for accuracy and completeness before submitting it to the Dekalb Pediatric Center.
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Follow any additional instructions provided by the center to complete the registration process.
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Keep a copy of the completed form and associated documentation for your records.

Who needs dekalb pediatric center?

01
Parents or legal guardians of children requiring pediatric care can benefit from the services provided by Dekalb Pediatric Center.
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Children of various ages, from infants to adolescents, who require routine check-ups, vaccinations, medical diagnosis, or treatment can also avail the services at the center.
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Anyone seeking reliable and professional medical care for children residing in Dekalb County or nearby areas can consider visiting the Dekalb Pediatric Center.
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Dekalb Pediatric Center is a medical facility that specializes in providing pediatric care for children.
Parents or guardians of children seeking medical care at Dekalb Pediatric Center may be required to file pertinent information for treatment purposes.
To fill out Dekalb Pediatric Center form, individuals need to provide accurate information about the child's medical history, insurance details, and contact information.
The purpose of Dekalb Pediatric Center is to provide quality medical care and treatment to children, ensuring their well-being and health.
Information such as child's medical history, current symptoms, insurance details, contact information, and any allergies or medications must be reported on Dekalb Pediatric Center form.
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