We are excited that you have chosen Reis Pediatrics 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
To provide accessible, high quality pediatric healthcare for our community by passionately promoting health and wellness in a supportive environment.
Patient Forms
Welcome to our practice! Please call our office at (808) 263-8822 prior to registering so we can gather the necessary information and better serve you.
After you have spoken with our office, you may begin the registration process. If you need assistance with the registration process at any point, please call our office.
Step 1
:
Please complete all of our online new patient paperwork below. Before signing the Patient-Provider Agreement Form, review our Patient-Provider Agreement and Notice of Privacy Practices. You may print the forms and fax them to 808-261-6749 or email them to
[email protected]
.
If you prefer to bring the forms with you to your appointment, please arrive 15 minutes early so our office staff will have time to review and input.
Step 2: Obtain a copy of your child's immunizations. Please bring the immunization records to our office, email them to [email protected] or fax them to (808) 261-6749 prior to your first visit if possible.
Step 3 : Appointment time! We look forward to meeting you and your child. You may request an appointment online or call our office at (808) 263-8822 during office hours and our staff will be happy to assist you.
New Patients (Newborn – 2 months):
- Registration Form [PDF] [Online Form]
- Medical History for Prenatal and Newborns [PDF] [Online Form]
- Medical Decision Authorization [PDF] [Online Form]
- Records Release (if needed) [PDF] [Online Form]
- Patient-Provider Agreement Form [PDF] [Online Form]
(Before signing the Patient-Provider Agreement Form please review our Patient-Provider Agreement and Notice of Privacy Practices)
New Patients (2 months and older)
- Registration Form [PDF] [Online Form]
- Medical History for 2 Months and Older [PDF] [Online Form]
- Medical Decision Authorization [PDF] [Online Form]
- Records Release [PDF] [Online Form]
- Patient-Provider Agreement Form [PDF] [Online Form]
Before signing the Patient-Provider Agreement Form please review our Patient-Provider Agreement and Notice of Privacy Practices
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.