Pediatrician - Birmingham
5000 Southlake Park, Suite 250
Birmingham, AL 35244
(205) 982-2500
F: (205) 982-2574
After Hours phone: (205) 930-4161

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We are excited that you have chosen Southlake Pediatrics, Inc. for your child's medical care. Your comfort and convenience are our priority, and we strive to make every visit to our office a positive experience. To help you get acquainted with our office and first visit procedures, we have included helpful information on this page.

Our Mission

Our practice is working together to build life-long relationships between our staff and our patients by consistently providing our patients with compassion, excellence and value. To fulfill this mission, we are committed to:

  • Improving the lives of the children we serve by providing quality care in a child-centered environment.
  • Listening to our young patients and their families who we are privileged to serve.
  • Guiding our patients along a path of optimal health and wellness.
  • Continually pursuing excellence at all levels through continuing education.

Patient Forms

To expedite your first appointment, please arrive a few minutes early to complete registration forms so that we have all the necessary information to treat your child. You may also download and print the forms from this website, fill them out ahead of time, and bring them with you to the first appointment.

DEMOGRAPHIC FORM

COMMUNICATION AUTHORIZATION FORM

ACKNOWLEDGEMENTS AND PERMISSION FORM

SOUTH LAKE PEDIATRICS POLICIES AND PROCEDURES

NOTICE OF PRIVACY PRACTICES

SOUTHLAKE PEDIATRICS VACCINE POLICY STATEMENT

WELL CHILD APPOINTMENT FORMS

2 weeks

6-8 weeks

4 months

6 months

9 months

12 months

15 months

18 months

24 months

3 years

4 years

5 years

6-7 years

8-9 years

10-11 years

12-13 years

14-15 years

16-17 years

18-20 years

SCHOOL MEDICATION FORM

SPORTS PHYSICAL EVALUATION FORM

  • Page 1 (print, fill out completely & sign)
  • Page 2 (print & bring to your visit)

(If you're in college, each school may have their own form that needs to be filled out. Please check with your college and make sure that you are prepared with the form that they will accept)

ADD/ADHD EVALUATION FORMS

In order to view or print these forms, you will need Adobe Acrobat Reader installed. Click here to download it.

What to expect

A pleasant, comfortable first visit builds trust and helps put the child at ease during future visits. We want your child to enjoy getting to know our doctors and staff, so we work hard to establish this bond during every appointment to our office. During your initial appointment, we will explain everything in detail and answer any questions you may have.

We look forward to meeting you and your child and providing the quality, comprehensive medical care you expect and deserve.

Directions

 

 

We've made requesting an appointment easy. Simply click below to request your appointment now.

Choosing a pediatrician is an important and personal decision and we want you to feel at ease with the care you and your child will receive.

An online resource center providing you with additional helpful information.

Call (205) 982-2500
Fax (205) 982-2574

5000 Southlake Park, Suite 250,
Birmingham, AL 35244