IMMUNIZATION FORM REQUEST


PLEASE REQUEST YOUR IMMUNIZATION FORMS VIA THE PATIENT PORTAL FOR FASTER SERVICE. INCLUDE YOUR CHILD'S NAME, DATE OF BIRTH AND THE FAX NUMBER FOR US TO SEND RECORDS. IF YOU WOULD LIKE US TO EMAIL TO YOU, PLEASE NOTE THAT WE WILL HAVE YOUR WRITTEN PERMISSION TO SEND VIA FAX TO AN UNSECURE EMAIL ADDRESS. YOU MAY ALSO PICK UP YOUR FORMS AT ANY OF OUR OFFICES.

Privacy Statement for Gwinnett Pediatrics
Sitemap for Gwinnett Pediatrics