Patient Forms

We have online forms available for downloading to help expedite your visit.


What to Bring

Use this handy list to remember what documents you need to bring to your visit



We are located on Johnson Ferry Rd between Post Oak Tritt Road and Shallowford Road.
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Our office is committed to providing the best possible treatment, as well as assisting you with insurance filing and payment of your account. In order to accomplish this in a cost effective manner, we ask that you read and follow these guidelines:

Please bring your child’s insurance card to every visit.

We participate with most private insurance plans including: Please contact our billing department at 678 323-3211, or your insurance carrier if you have questions regarding our participation in your plan. PLEASE NOTE: WE ARE NOT IN NETWORK WITH HUMANA HMOX NOR KAISER HMO.

Pediatric Associates, PC will be happy to file claims on your behalf, as long as we participate in your insurance plan. Please provide us with your current insurance card at each visit, as well as alerting the front office staff to any changes in your coverage or your demographic information. If you do not have this information, we may require payment in full at the time of service.

Since every insurance policy is different, we ask that you familiarize yourself with your plan’s coverage, benefits and plan exclusions before you arrive for your appointment. Your copay is due at the time of service and will be collected upon your arrival. Additionally, you are responsible for any deductibles, non-covered services and pre-existing conditions. We will bill you for these services after your insurance has processed the claim, and payment is due upon receipt of your statement.

If we are unable to collect from your insurance company in a timely manner, all charges will ultimately become the responsibility of the parent/guardian who brought the child to our office.

We do offer a private pay plan for those whose insurance we do not accept, or for those patients who are uninsured. Please call our billing department at 678 323-3211 for more information.

To see our complete financial policy, please click here.


Referrals: HMO/POS

Because of the large number of referral requests that managed care has imposed upon all of us, it has become necessary to ask that patients provide at least 72 hours prior notice to our office to complete their referral. This will allow the physicians and their staff to review the chart and to properly complete and forward the referral.