Patient Forms

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As a convenience to you, we have posted several forms we commonly use in our practice.

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  • FAQNew Patient Form
    If you would like to join our practice, please click on the above link and fill out the form. If you are a member of a CHP employer group health plan with medical clinic benefits, please call us directly to become a patient.


  • FAQAuthorization to Disclose Protected Health Information
    If you would like to release your protected health information from Grand Valley Pediatrics please fill out this form.