Patient Forms
Before your first visit, completing the New Patient Registration Form below can save you time. You may bring it with you or feel free to mail or fax it to us in advance. During your visit, you’ll need to sign a couple of required forms. If you choose to send your information ahead of time and sign up for our Patient Portal, we can conveniently send those documents to you to sign electronically. One of these is the Acknowledgment of our Privacy Practices (the “HIPAA form”) which is included below for your review.
Please click on the icon below to download an Adobe Reader® file
If you don’t have a copy of Adobe Reader on your computer, please click here for a free download.
Immunizations
We strongly believe in the importance of immunizations for the health and safety of our patients, families, and staff. To protect everyone, we require all patients and staff to be fully immunized according to the CDC schedule. We invite you to reach out with any questions you may have regarding immunizations or our policy.
Patient Portal
Our electronic health record system features a patient portal designed to enhance your experience in managing your children’s healthcare. Accessible 24/7 via smartphone, tablet or computer at https://elemental.pcc.com/portal, the portal includes several valuable features:
- View and print immunization records
- Request appointments
- Send and receive secure messages
- View upcoming appointments
- Check in and complete screening questionnaires before your appointments
- Review and pay bills
- Access visit notes
- View lab and test results
- Review problem lists and allergies
- Request medication refills
- Request referrals
- Update your address, phone and insurance information
If you haven't signed up for the portal yet, please let us know during your next visit or call us and we will assist you in the signup process!
A Note About Telehealth
We are happy to offer telehealth visits for nearly any reason. A few visits may require an in-person follow-up, but most can be resolved completely online. This convenient service allows you to receive care at a time and location convenient for you and can be done during office hours or on evenings or weekends. The only requirement (based on state law) is that the patient be in the state of Missouri. We look forward to providing this service to you. Please call or send us a portal message to set up your telehealth visit today.