Policies & Forms
Learn about the policies that help us provide you with the very best of care.
Forms & Downloads
New Patient Forms
- Patient QuestionnaireFor newborns up to two months old.
- Patient QuestionnaireFor children under two years old.
- Patient QuestionnaireFor children two years and older.
- Family Information FormContact and insurance information.
- Adolescent Information FormContact and insurance information for patients 18 years and older.
- Record ReleaseAuthorize the sharing of medical records between health care providers.
- Authorization FormAllow family members or others to access patient or billing information.
- Notice of Privacy PracticesPlease review this document carefully.
- No Show PolicyPlease review this document carefully.
- Credit Card On File PolicyPlease review this document carefully.
- Re-Billing Fee PolicyPlease review this document carefully.
Authorization Forms
- Record ReleaseAuthorize the sharing of medical records between health care providers.
- Authorization FormAllow family members or others to access patient or billing information.
Financial Forms
- Financial PolicyOur complete payment and insurance policies.
Patient Education
- AAP Parent Education HandoutsBrowse this library of expert advice from the American Academy of Pediatrics. This collection of over 800 handouts covers 200 topics ranging from Acne to Whooping Cough.
Appointment Policies
- An appointment is required for each visit.
- Regular office hours are from 8:30-5:00, Monday through Friday.
- We are also available to see sick children on Saturdays. There is an additional charge for office visits on Saturdays and after 5:00 PM weekdays.
Appointments are for your benefit, they minimize your waiting time. If more than one child is to be seen, please set up an appointment for each child.
Missed Appointments
We ask that you notify the office as soon as possible if you are unable to keep an appointment. Twenty-four hour notice is appreciated as it allows the time to be used to meet the needs of other patients. Missed appointments hinder your child’s health care as well as others. Frequent no-show offenses may jeopardize your relationship with our practice.
After-Hours Care
If your child’s illness or injury is life-threatening, call 911.
Otherwise, for urgent matters that cannot wait until regular office hours, call our answering service at (918) 747-7544. They will page one of our pediatricians.
If you don’t hear from us in half an hour, please call back. Messages are sometimes relayed incorrectly. If desired, you can leave a message on our voice mail. Messages are reviewed the morning of the next office day.
Emergencies
Should an emergency arise during office hours please call us directly. After office hours, contact us through the answering service as above. Tell the operator that you have an emergency. Your call will be handled immediately.
If time permits it is best to call us before rushing your child to an emergency room or minor emergency center. We can then advise you on the best course of action.
We Are a Vaccinating Practice
We firmly believe in the effectiveness of vaccines to prevent serious illness and to save lives.
We firmly believe in the safety of our vaccines.
We firmly believe that all children and young adults should receive all of the recommended vaccines according to the schedule published by the Centers for Disease Control and Prevention and the American Academy of Pediatrics.
We firmly believe, based on all available literature, evidence, and current studies, that vaccines do not cause autism or other developmental disabilities.
We firmly believe that thimerosal, a preservative that has been in vaccines for decades and remains in some vaccines, does not cause autism or other developmental disabilities.
We firmly believe that vaccinating children and young adults may be the single most important health promoting intervention we perform as Pediatricians, and that you can perform as parents/caregivers. The recommended vaccines and the vaccine schedule are the results of years and years of scientific study and data gathering on millions of children by thousands of our brightest scientists and physicians.
As medical professionals, we feel strongly that vaccinating children on schedule with currently available vaccines is absolutely the right thing to do for all children and young adults. Thank you for your time in reading this policy, and please feel free to discuss any questions or concerns you may have about vaccines with any one of us.
Finally, if you should absolutely refuse to vaccinate your child despite all our efforts, we may ask you to find another health care provider who shares your views. We do not keep a list of such providers, nor would we recommend any such health care provider. Please recognize that by not vaccinating you are putting your child at an unnecessary risk for life-threatening illness and disability, and even death.
Vaccine Resources
Medication Refills
Requests for routine medication and refills on prescriptions should be made during office hours when we have access to your records. It is helpful for you to know the name and number of your pharmacy so we can call in the prescription. Routine, non-emergency prescriptions will not be refilled after office hours.
ADD/ADHD Medications
Please note: ADD/ADHD medication refills may take up to 3 business days. To refill these medications:
- Login to our Patient Portal.
- Click “Create Message”.
- Select patient name, select subject Medication Refill Request, and then click “Start Message”.
- Select the medication to refill. If the medication does not appear, enter it in the “Other Medication” box.
- Enter your pharmacy information.
- Click Send.
Pediatric & Adolescent Care
Phone
(918) 747-7544
Phone lines open at 8:00 am.
Location & Parking
2000 South Wheeling Ave
Suite 300
Tulsa, OK 74104
We are conveniently located in the Williams Medical Plaza on the Ascension St. John Campus at the intersection of 21st Street and Wheeling Avenue, across the street from Utica Square.
Please enter the 21st Street Parkade off of Wheeling Avenue, just north of the Williams Medical Plaza. You may park in our reserved section on the 3rd floor, just outside the office.
Office Hours
Monday - Friday
8:30 am - 5:00 pm
Saturday
See below
Sunday
Closed
Please call us to schedule an appointment or speak to a triage nurse.
Special hours are offered on weekdays after 5:00 pm and Saturday mornings, based on the needs of sick and injured patients. There is an additional charge for services during these hours.
After-Hours Care
If your child’s illness or injury is life-threatening, call 911.
Otherwise, for urgent matters that cannot wait until regular office hours, please call our answering service at (918) 747-7544. They will page one of our pediatricians to return your call.
If time permits, it is best to call us before taking your child to an emergency room or urgent care center. We can then advise you on the best course of action.
POISON CONTROL HOTLINE
1 (800) 222-1222
