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Children's Choice Pediatrics
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    • Cheryl Eley, MD, FAAP
    • Stacie Hunsaker, CPNP
    • Jackeline Bobadilla, MSPAS, PA-C
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Patient Information

New Patient Forms

Before your child’s first visit, please print and complete these forms and bring them with you to the appointment.

These forms are in PDF format for easy printing. To get a free copy of Adobe Acrobat Reader, click here

New Patient Forms

CCP Notice of Privacy PracticesCCP Referral SourceLetter to Our ParentsCCP Patient Registration FormVerification of Benefits Signature FormGuarantor and Insurance InformationFamily History – EnglishTreatment Authorization for MinorsCCP Disclosure Regarding Ancillary ServicesCCP Financial Responsibility AgreementChildrens Choice Pediatrics IMMTRAC FormCCP ADD ADHD PolicyCCP Release of Information Form

New Patient Forms (Espanol)

CCP Notice of Privacy Practices (Esp.)Letter To Our Parents (Esp.)CCP Patient Registration Form (Esp.)Guarantor and Insurance Information (Esp.)Family History (Esp.)Treatment Authorization for Minors (Esp.)CCP Disclosure Regarding Ancillary Services (Esp.)CCP Financial Responsibility Agreement (Esp.)Release of Information Form (Esp.)Childrens Choice Pediatrics IMMTRAC Form (Esp.)NICHQ Vanderbilt Assesment (Esp.)TVFC Program (Esp.)

ADD/ADHD Forms to Complete

New CCP ADD ADHD PolicyNICHQVanderbiltAssessment-ParentNICHQVanderbiltAssessment-TeacherConnors Parent Short FormConnors Teacher Short Form
Children's Choice Pediatrics

Children's Choice Pediatrics has been serving the greater McKinney area since 2004.

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