Forms & DownloadsOffice
PoliciesAfter-Hours CareVaccination Policy

Forms & Downloads

New Patient Forms

  • New Patient RegistrationOur new patient forms can be completed through our patient portal.
  • Records Release AuthorizationWe require that you sign a records release form 30 days before a well check is scheduled for us to be able to obtain the child’s medical records from the previous physician.

Authorization and Consent Forms

Policy Documents

Assessments

School Forms

Office Policies

Prepare for Your Appointment

  • Please make sure that you have confirmed your upcoming appointment via text, email, or phone call appointment verification.
  • Most well child visits have parent/patient forms that must be completed prior to your appointment. iPads are available in the office to complete forms, but for your convenience please try to complete these forms before coming in for your appointment.

Appointments

  • We value the time we have set aside to see and treat your child. If you are not able to keep an appointment, we require a 24-hour notice.
  • Multiple failures to give appropriate notice may result in dismissal from Willow Tree Pediatrics.
  • You will be notified of a missed (no-show) appointment and associated fee by letter.
  • If you are late for your appointment (>15 minutes), we will do our best to accommodate you. However, on certain days it may be necessary to reschedule your appointment.
  • Children under the age of 14 must be accompanied by an adult for all visits.

Wellness Care

  • The purpose of a well visit (preventative care visit) is to review overall health, identify risks to health, and learn how to keep your child healthy.
  • Wellness care is an essential part of keeping your child healthy and regular check-ups are required by Willow Tree Pediatrics.
  • Patients who do not have preventative coverage can receive this service at a discounted rate if paid at the time of service.
  • New patients will not be scheduled for well child check-ups before Willow Tree Pediatrics has received records from the child’s previous provider.
  • Newborns must bring records or have records faxed from the hospital for the first appointment.
  • If you schedule a preventative care visit and ask the doctor about specific problems, concerns, illness, or prescriptions a diagnostic visit by the provider may be required and will be billed to your insurance, if necessary. Your insurance may charge you a copay or deductible for the visit.
  • If you schedule a preventative care visit and your child is acutely sick requiring treatment, a diagnostic visit by the provider is required and will be billed to your insurance. Your insurance may charge you a copay or deductible for the visit.

Forms & Medical Records

  • There is no charge for a certificate of immunization given at the time of your child’s visit.
  • There is no charge for 1-2 page physical or medication forms presented at the time of your child’s visit.
  • Any additional forms are subject to a $7.00 flat fee plus $3.00 per page. We require a 72-hour turnaround time.
  • Copying of medical records is available with a $5.00 flat fee plus $1.00 for pages 1-25 and $0.50 for pages 26 and over.
  • We provide copies of records of your child’s visits with Willow Tree Pediatrics only. All records for outside facilities or providers should be obtained from them directly.

Referrals

  • Advance notice is needed for all non-emergency referral initiation, typically 2 business days.
  • Referral appointment scheduling may take up to two weeks for completion.
  • It is your responsibility to know if a selected specialist participates with your insurance.

Prescription Refills

For medication refills, we require a 48-hour notice, during regular business hours. Please plan accordingly.

After-Hours Care

If your child’s illness or injury is life-threatening, call 911.

Triage Nurse

Call our office for instructions on reaching a triage nurse after hours, or call (256) 737-2000 and ask the operator to take a message for the triage nurse to call you back. If necessary, the nurse will contact Dr. Blair.

Hospitals / Emergency Rooms

Local hospitals we recommend for emergency treatment:

Children’s Hospital of Alabama
Dr. Blair has active privileges
Map & Directions »

Cullman Regional Medical Center
Dr. Blair has outpatient privileges
Map & Directions »

Huntsville Hospital for Women & Children
Pediatric Emergency Room
Map & Directions »

Vaccination Policy

Willow Tree Pediatrics has carefully reviewed our approach to vaccinations in our practice. We believe in the effectiveness of vaccines to prevent illness and to save lives.

We follow the immunization guidelines provided by the American Academy of Pediatrics (AAP) and the Centers for Disease Control (CDC). A copy of the schedule will be provided upon request.

Scientific research has consistently shown that vaccines are safe and effective in preventing diseases in children and adults. It is safe to give multiple or combination vaccines at the same office visit. Based on evidence and current studies, we do not believe that vaccines cause autism or other developmental disabilities.

Please be advised that delaying or splitting up vaccines to give one or two at a time goes against expert recommendations and is against our advice as health care providers at Willow Tree Pediatrics. Delaying or limiting vaccines can put your child at risk for harm by leaving them vulnerable to deadly diseases. We do not recommend that parents pick their own schedule.

  • We respect the rights of all parents/ guardians to make decisions and understand that you want what is best for your children.
  • We recognize that the choice to vaccinate may be a very emotional one for some parents.
  • We will do our best to provide education and information that vaccinating according to the CDC schedule is the appropriate thing to do for your children.

Thank you for your time in reading this policy and please discuss any questions you may have about vaccines with any one of our medical staff.

Immunization Resources