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GLENDALE PEDIATRICS A PROFESSIONAL CORPORATION 1500 EAST CHEVY CHASE DRIVE, SUITE 250 GLENDALE, CALIFORNIA 912064139 RICHARD H.SEVILLE. JR., M.D. JENNIFER A BERNSTEIN, M.D. JAMES C. HENRY, M.D. BRADLEY
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How to fill out glendale pediatrics alternate caregiver

01
Obtain the alternate caregiver form from Glendale Pediatrics.
02
Fill out your child's information including name, date of birth, and any medical conditions or allergies.
03
Provide contact information for both the primary caregiver and the alternate caregiver.
04
Make sure to sign and date the form before submitting it to Glendale Pediatrics.

Who needs glendale pediatrics alternate caregiver?

01
Parents or legal guardians who anticipate needing someone else to care for their child in case of emergency or unforeseen circumstances.
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Glendale Pediatrics alternate caregiver is an individual designated by a parent or guardian to care for their child in case of emergency or unavailability.
Parents or guardians of children under the care of Glendale Pediatrics are required to file alternate caregiver information.
To fill out the Glendale Pediatrics alternate caregiver form, parents or guardians need to provide the designated individual's contact information, relationship to the child, and any special instructions for care.
The purpose of the Glendale Pediatrics alternate caregiver form is to ensure that there is a designated individual who can care for a child in case of emergency or when the parent/guardian is unavailable.
The information required on the Glendale Pediatrics alternate caregiver form includes the caregiver's name, contact information, relationship to the child, and any special care instructions.
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