Sprout Policies
Notice of Privacy Practices (Hipaa form)
Introduction to Sprout Pediatrics: General Policies
Sprout Pediatrics Immunization Policy
*NEW* Chaperone information
Sprout Policy
Legal / FAQ’s
*NEW* Sick & Well visit insurance payment policy
Sprout forms
Patient information & consent (registered on portal)
Welcome & Sprout User Guide (registered on portal)
Expecting Parents Hospital and Clinic instructions
Health History (parent completes)
Health History (adolescent completes; coming soon)
Authorization for another provider to release information to Sprout Pediatrics:
Authorization to release information from Sprout Pediatrics to another provider
Acknowledgement of Receipt of Notice of Privacy Practices (Hipaa release)
Self-pay & non-covered services agreement
[refers to Recommendations for Preventive Pediatric Health Care from Bright Futures 4, the recommendation consensus from the American Academy of Pediatrics and the US Preventive Services Task Force (USPSTF).]
Helpful printables
Sprout acetaminophen & ibuprofen dose card
Monster Spray label for empty, clean spray bottles
Blank calendars for schedules, symptom calendars, behavior charts and family contests.
Chart for keeping track of alternating or scheduled medication (please ask me before alternating tylenol and ibuprofen) to help avoid errors & over-dosing.
Scheduled medicines or alternating chart (blank)
School & Activity forms
Sports Physical form (In Spanish)
HIPAA/FERPA Release: Permission for school to share information with us.
ADHD Questionnaires (Vanderbilt forms)
“Listen earnestly to anything your children want to tell you, no matter what. If you don’t listen eagerly to the little stuff when they are little, they won’t tell you the big stuff when they are big. Because to them all of it has always been big stuff.
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