In order to make your first appointment run smoothly we suggest the following:

Please review our Forms and Polices prior to arriving for your first appointment.

• New Patient Packet (English)
• New Patient Packet (Spanish)
• Medical Release
• Financial and Insurance Policies
• Notice of Privacy Practices

(You will need Adobe Acrobat Reader to download these forms. Click Here to download a free copy of Acrobat Reader).

Please print and complete the New Patient Packet, which must be signed by a responsible parent or legal guardian.

Please bring them with you when you come for the appointment.

Also Remember to Bring:

• Proof of medical insurance.
• Photo ID or Florida Drivers License.
• Previous Medical History Documents, if available.

Copayment

• HMO and most PPO/EPO require us to collect co payment from you, at the time of service. We accept cash, credit cards.

Loop Pediatrics PA
1144 Cypress Glen Circle
Kissimmee Fl 34741
Ph: 407-483-5900 // Fax: 407-483-5902
All Major Insurances & Medicaid Accepted
Office Hours: Monday-Friday 9:00 AM – 1:00 PM and 2:00 PM – 5:00 PM
Saturday: 9:00 AM - Noon