13132 Newport Ave #100  Tustin, CA   92780               Phone (714) 565-7960     Fax (714) 565-7982
Pediatric & Adult
Medicine,Inc.
The following forms are available for download.
Once the form is completed - you may fax it to us at (714) 565-7982.


New Patient Registration Form

Consent for Treatment

ADD Medication Refill Request

Physician's Report - Child Care Center

Report of Health Examination For School Entry

Orange County School Medication Form