For Our Patients

Below is information and a number of forms designed to make your visits at Pinwheel Pediatrics more productive and informative. Filling out many of these forms and forwarding them to us in advance can save you a great deal of time. You may email them to


Health care insurance is intended to cover some, but not all of the cost of your medical treatment. Please familiarize yourself with your specific policy by contacting your benefits office or by calling the phone number listed on your insurance identification card. You should be aware of any deductibles, coinsurance, and co-payments, as well as non-covered services.

Pinwheel Pediatrics currently participates with the following insurance plans:

Aetna US Healthcare HMO, PPO, and POS
Anthem Blue Cross & Blue Shield PPO and HMO
Cigna PPO and HMO
Pacific Care PPO and HMO
United Health Care HMO, PPO,POS
PHCS PPO (Private Health Care Systems)
Great West PPO and HMO
First Health PPO and HMO


In order to make your visit at Pinwheel Pediatrics more informative and efficient, we have made the below form available for you to download in advance of your visit with us. Please complete the registration form and the appropriate medical history form for your child's age and bring it to your appointment. Our friendly registration staff will take it from there. Also bring a copy of your child's vaccine records in addition to any other medical records you think the doctor should see. The forms below are PDF.

Download Registration Form



Download Infants and Children Up to 5 Years of Age

Download Children from 6 Years Old to 12 Years Old

Download Adolescents 13 Years and Older


Inevitably bringing home a newborn is a bit scary and we hope to ease that fear by anticipating the questions you will confront as you care for your child in his or her first days. The booklet below coupled with frequent meetings with your pediatrician will guide you through these exciting days! Think of it as an owner's manual, a how-to book.

Download NEWBORN Booklet


Pinwheel Pediatrics remains dedicated to preserving the health of children and adolescents. One of the most important steps in achieving this goal is immunizations. A great deal of information about vaccines is scattered across the news and the internet; much of it is inaccurate. We encourage you to bring your questions and concerns to your appointments and discuss them with our staff. Below you will find useful information concerning individual vaccines and the recommended schedule.

Vaccination Schedule - Recommended by the American Academy of Pediatrics and the Advisory Committee on Immunization Practices. Click here

Booklet on Vaccinations - A short book designed specifically for parents explaining the need for vaccinations and descriptions and possible side effects of individual vaccines. Click here

Common Side Effects - The most common side effects of vaccines include fever, irritability, and swelling & redness at the site of the vaccine. For more information concerning these common side effects, click here.
For Tylenol® dosing you may click here.

Thimerosal - Today, with the exception of some flu vaccines, thimersol is no longer used as a preservative in any vaccines. The vast majority of studies involving hundreds of thousands of children in many countries, have found no association between thimerosal used in vaccines and autism.
For more information click here Mercury and Thirmerosal


Chickenpox (varicella)



Hepatitis A

Hepatitis B

Hemophilus Influenza B

Human Papilloma Virus (Gardasil)





Rota Virus

Tetanus Booster



Medical records can be obtained from our office within 7-10 days of a signed written consent. Any patient who is over the age of 18 must sign for the release of their own medical records. There is a fee of $20 per chart for copying records. These requests are best made via fax as they require a signed statement allowing for release of these records. Please fax them to (925) 827-9278.

Download Medical Records Release Form


To have camp, school, and other forms completed there is a fee of $10. Your child must also have had a physical examination within 1 year of completion of the form or as current as required by the form. Requests for completion of camp forms and school forms may be made via fax or email.


We all know that, chances are, when your child gets sick, it isn’t going to be during regular business hours. If you are needing an advice or an appointment when our office is closed, please call After Hours Care at 925 296-9001. The clinic is located at 1450 Treat Blvd in Walnut Creek. Please note that for patients with Tricare or Hill Phycisians insurance, the number to call after hours is 925 297-6396 and the address is 970 Dewing Ave., Suite 100B in Lafayette.

Copyright © 2008 Pinwheel Pediatrics. All rights reserved.