RECORDS AND FORMS

There is a $25.00 charge for medical records. Please allow up to 15 days in order for us to have the records copied. There is no limit to the amount of records that we will copy. There is a $5.00 charge to print a copy of a shot record for a patient, this is why we encourage parents to bring in their child's shot records each visit. Call 468.6277 to request copies.

Please take a moment to print the following forms prior to your first visit: the Patient Information Sheet and the HIPAA Signature Form. We have also included specialty forms that can be printed upon the request of your physician, patient information forms that you can view and read, and some informational pieces regarding immunizations.

Please contact us if you have any additional questions.

PATIENT FORMS - Please print these.
• Patient Information Sheet
• HIPPA Signature Form
• Texas Vaccines for Children Eligibility Screening Record

SPECIALTY FORMS - Print upon request of physician.
• Medical Records Release Form

PATIENT INFORMATION - These are for your infomation, you do not need to print these for your office visit.
• HIPPA Privacy Notice
• Amarillo Children's Clinic Welcome Letter
• Medical FAQ

VACCINE FORMS
• Vaccine Policy Statement
• Human Papillomavirus
• The Facts About Childhood Vaccines
• Vaccines and Autism
• Too Many Vaccines?