Forms

Download Our Forms Before Your Appointment

At Ching's Pediatrics, we strive to provide hassle-free and exceptional pediatric services for your child. Download and fill out these forms before your next visit. Contact us for more details.

Patient Information

Patient Information(Spanish)

Notice of Privacy Practices

Notice of Privacy Practices (Spanish)

HIPAA

HIPAA - SPANISH

Text Release Form

Release Form (Spanish)

Release of Medical Record

Release of Medical Record - Evanston

PCP CHANGE FORM - AETNA

PCP CHANGE FORM - ANTHEM/MEDICAID

PCP CHANGE FORM - HEALTH PLAN OF NEVADA

PCP CHANGE FORM - SILVER SUMMIT MEDICAID / AMBETTER