Forms and Records

Enrollment Document

Please feel free to download the enrollment form (you'll need Adobe Reader) for Kids First Pediatrics Patient(s). You may enroll more than one child on the same form. Please feel free to fax us the form at (704) 542-5227, bring it to your first scheduled appointment or mail it to us at:

Kids First Pediatrics
8169 Ardrey Kell Road
Charlotte, NC 28277.

Transferring Your Records

Please feel free to download the records transfer form (you'll need Adobe Reader) for Kids First Pediatrics Patient(s). Please feel free to fax us the form at (704) 542-5227, bring it to your first scheduled appointment or mail it to us at:

Kids First Pediatrics
8169 Ardrey Kell Road
Charlotte, NC 28277.

Other Forms

Effective January/2012 our fees associated with the completion of any forms by a doctor have changed. The charges will be $10.00 for 3 business days, or $20.00 for 1 business day. This includes, but is not limited to: school & daycare enrollment forms, athletic participation forms, and camp registration forms.

There will NOT be a fee for the completion of required Medication Consent Forms, Asthma Action Plans, and Kindergarten Assessments. The fee will also not apply to any forms brought to the Well-Visit.

Policies and Consent

Please feel free to download the Policies and Consent form (you'll need Adobe Reader) for Kids First Pediatrics Patient(s).

Need Your Medical Records

Your child’s medical records at Kids First Pediatrics are always available for you. There is a $20.00 administration fee per record, and please give 48 hours notification of your request. This request must be in writing, by letter or by form. We offer an acceptable form for you to download and print. (you'll need Adobe Reader)

If you have changed any pertinent information, please fill out this form (you'll need Adobe Reader) and fax it to our office. Thank You.

Kids First Mailing Program and Other Options for Mailings

Kids First Pediatrics offers our patients several options to receive mailings from Kids First Pediatrics:

  • Kids First will mail any required mailings to a family/patient for a fee of $15.00 per family per year. This includes any prescriptions, medical forms, immunizations (but does not include full medical records).
  • Or, you can provide Kids First with self-addressed stamped enveloped for required mailings. If you require monthly prescriptions, we can keep several self-stamped envelopes in your child's chart for your convenience.

This site is for information only. The information contained on this site should NOT replace the advice recommended by your doctor. No medical questions will be addressed from this web site. If you have a medically related question or concern, please call our office at (704) 542-5540 or contact us by fax at (704) 542-5227. Thank you for visiting the Kids First Pediatrics website!