Forms & Policies


Please download the form below, print both pages and fill out all information prior to your appointment. Thank you.

Use this form to transfer records to or from Mountain View Pediatrics and another facility. Download the form below, print it and fill out all information. You can then mail, fax or bring it to our office. Please allow 1 week for records to be ready for pick up or mailing.

Use this form to allow schools, daycare providers, relatives or friends to obtain medical information or pick up prescriptions for your child. Download the form below, print it and fill out all information. You can then mail, fax or bring it to our office. Please allow at least 2 weekdays for information to be released.

This form explains our office and billing policies. Download the form below, print it and fill out all information. You can then mail, fax or bring it to our office.

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