We are excited that you have chosen Haywood Pediatrics for your child's medical care. Your comfort and convenience are our priority, and we strive to make every visit to our office a positive experience. To help you get acquainted with our office and first visit procedures, we have included helpful information on this page.
Our Mission
Our practice is working together to build life-long relationships between our staff and our patients by consistently providing our patients with compassion, excellence and value. To fulfill this mission, we are committed to:
- Improving the lives of the children we serve by providing quality care in a child-centered environment.
- Listening to our young patients and their families who we are privileged to serve.
- Guiding our patients along a path of optimal health and wellness.
- Continually pursuing excellence at all levels through continuing education.
Requesting a Well-Child Appointment
To request an appointment, please fill out our online Appointment Request form. If you're child is sick, please follow the instructions here or call us at (828) 452-2211 .
Patient Forms
To expedite your first appointment, please arrive a few minutes early to complete registration forms so that we have all the necessary information to treat your child.
PATIENT UPDATES
- New Patient Demographics : This form is filled out by all new patients (with the exception of foster parents, see below for those) and gives us information such as address and phone number.
- New Patient Demographics - En Español: Este formulario es llenado por todos los nuevos pacientes (excepto para los padres adoptivos, ver más abajo para éstos) y proporciona información como la dirección y número de teléfono.
- Patient Information Update : This form is filled out yearly to update HIPAA and address and phone numbers. Up to 4 children may be listed on this form. This form is used with the exception of 18 year old and older and foster parents, see below for those.
- Patient Information Update - En Español: Este formulario es llenado anualmente para actualizar HIPAA, dirección y números de teléfono. Hasta 4 niños pueden estar señalados en este formulario. Este formulario se utiliza con la excepción de los pacientes18 años de edad y mayores y los padres de crianza, ver más abajo para esos.
- 18 Year+ Update : This form is to be completed by the patient themselves for any patient that is 18 years or older when they turn 18 and every year thereafter.
- Foster Parent Form : This form is to be completed by those that have temporary custody of a child (such as foster care, Broyhill Children’s Home, kinship, etc…) and every year thereafter for as long as they have temporary custody.
Community Resources
- Dental Listing: List of dentist in the area with phone numbers and insurance carriers.
- Psychological List : List of Psychologists/psychiatrists in the area with phone numbers and insurance carriers.
Forms:
- Consent To Treat Children (Other than Parent) : The purpose of these forms is to give permission for someone other than the parent or legal guardian to consent to medical care for a certain child. For example, if a parent/legal guardian is going out of town or is otherwise unavailable this notarized document can be included in the child's record. We do have a notary within our practice that can notarize office specific forms.
- Release of Information FROM Haywood Pediatrics:This form is used to release information from our practice to someone or somewhere else. Please remember only the parent or legal guardian may sign for records to be released.
- Release of Information TO Haywood Pediatrics: This form is used to release information to our practice from someone or somewhere else. Please remember only the parent or legal guardian may sign for records to be released.
Click here to download it.
What to expect
A pleasant, comfortable first visit builds trust and helps put the child at ease during future visits. We want your child to enjoy getting to know our doctors and staff, so we work hard to establish this bond during every appointment to our office. During your initial appointment, we will explain everything in detail and answer any questions you may have.
We look forward to meeting you and your child and providing the quality, comprehensive medical care you expect and deserve.
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