Pediatricians of Peninsula Pediatric Medical Group provide the highest quality care to children of all ages from the newborn baby to the adolescent teenager. Our physicians are certified by the American Board of Pediatrics and are members of the American Academy of Pediatrics. Our doctors see patients from San Mateo, Burlingame, Hillsborough, Millbrae, San Bruno, Daly City, Belmont, San Carlos, Foster City, Redwood City, Half Moon Bay Pacifica, Hayward and other cities in the San Francisco Bay Area.

 

Contact, Hours
& Locations:

Burlingame
San Mateo


Administrative:

Patient Forms
Billing / Insurance
Office Policies
Privacy Policies
 

Patient Forms

Dr. Marsh with baby

If your child is a new patient, you will be asked to complete the following two forms. You can do so before you arrive at the office by opening the following forms in Adobe Acrobat format*, then printing them out from your computer.

Patient Registration Form

New Patient Medical History Form

If you would like to have copies of your child's medical records or would like to transfer records to another physician's office, you will need to fill out the following form. For further questions, you should call our offices.

Form for Request of Medical Records

If an adult other than the patient's parent/guardian is bringing the patient to the office, we ask that the following consent form be filled out:

Authorization to Consent to Medical Treatment of a Minor


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