Accessibility View MENU 9197820021 Patient Portal Home > New Patients New Patients Patient Forms, Map and Directions to Raleigh Office Thank you for choosing Blue Ridge Pediatrics as your child's medical home, where we always provide a comfortable, caring environment so our patients and their families can feel at ease. We've included helpful items on this page to ensure you and your child's first trip to our office is productive, stress-free and enjoyable. Mission Statement Our practice is working together to build life-long relationships between our staff and our patients by consistently providing our patients with compassion, excellence and value. To fulfill this mission, we are committed to: Improving the lives of the children we serve by providing quality care in a child-centered environment. Listening to our young patients and their families who we are privileged to serve. Guiding our patients along a path of optimal health and wellness. Continually pursuing excellence at all levels through continuing education. If you're preparing for your child's first visit, you can do a few things to help expedite the appointment. Please provide the following information when you arrive for your visit: Insurance cards Complete immunization records Medical records from your previous pediatrician Patient Forms We are happy to provide our office forms for convenient download on your home computer. Please print and complete the forms below, and bring them with you to your child's first appointment. Questions about which forms you need? Please call our office and our courteous staff will assist you in preparing for your child's first visit. New Patient Forms Patient Registration Form Consent for Discloseure of Protected Health Information Patient Billing and Financial Policy Patient Acknowledgement and Consent Patient Communication Log Patient Education Feeding Schedule Immunization Schedule Safety Checklist Newborn Booklet Other Forms Records Request Form ADHD Forms Vanderbilt ADHD Diagnostic Form - Parent Informant Vanderbilt ADHD Diagnostic Form - Teacher Informant Vanderbilt Form - Parent Informant Vanderbilt Form - Teacher Informant In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it: The Initial Visit Our compassionate Raleigh pediatricians do whatever it takes to make every visit to our office a pleasant, relaxed experience. With all of the important information about our practice available on our website, you can feel confident that you and child are well-prepared for your first appointment. We also invite you to review our staff page in order to get to know our doctors and staff. We look forward to meeting you. Contact Us Send us an Email Today! Please do not submit any Protected Health Information (PHI). Our Location Find us on the map 10208 Cerny Street - Suite 104, Raleigh, NC, 27617, USA × + − Leaflet | Map data provided by Internet Brands Copyright © 2021 MH Sub I, LLC dba Officite. Admin Log In Site Map