Silver Springs Office: 352-625-2727       Dunnellon Office: 352-522-1862       Anthony Office: 352-509-5082 Ocala Office: 352-671-6741

  • Patient Portal

    • Forms

    Download Patient Forms

    Complete the forms requested by your Premier Pediatrics care team before your visit. English and Spanish downloads are labeled where available. PDFs open in a new tab.

    Need a form that is unavailable? Call (352) 671-6741 for the current form.

    ¿Necesita un formulario en español? Llame al (352) 671-6741 para solicitar ayuda.

    New Patient Forms

    Please bring to your first visit: caregiver’s driver license, insurance card, your child’s immunization records, medical records from the previous pediatrician, and hospital discharge paperwork for newborns.

    Established Patient Forms

    Behavioral & Mental Health — Initial Evaluation

    If you have concerns that your child may be showing symptoms of ADHD, Depression, Anxiety, Bipolar Disorder and other Mood Disorders, or other Mental Health disorders, please complete the applicable forms below and bring them to your next visit.

    Developmental Screening

    Behavioral & Mental Health — Follow-Up

    SCARED Child Version (if your child is being treated for anxiety)

    English · PDF

    SCARED Parent Version (if your child is being treated for anxiety)

    English · PDF

    Sliding Fee Policy & Application

    Premier Pediatrics offers discounts based on household size and income. Patients who qualify for a full discount are assessed a $10 nominal fee per visit. Patients will not be denied services because they cannot pay.

    Read sliding fee policyRequest application · (352) 671-6741
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