Patient Forms
To expedite your first appointment, please print and complete the registration forms below or call our office to have a copy of the forms sent to you via email or US mail. When your forms are complete, please return them to us via drop off, email, mail or fax.
Registration forms must be completed and sent to the office prior to scheduling your first appointment.
- New Patient Registration (17 yrs old and under)
- New Patient Registration (18 yrs old and up)
- Authorization for Agent (other than parent or legal guardian) to Consent to Treatment for a Minor
- Medical Records Request Form
To view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it.
Find Us
View map and directions to our location and office hours.
Larchmont Pediatrics
321 N. Larchmont Blvd,
Suite 1020
Los Angeles, CA 90004
(323) 960-8500
Quick Access
Sick Child?
For same day appointments, please call our office so
that we may get you in
as quickly as possible.
Parent Resources
An online resource center providing you with additional helpful information.
