Bright Star Pediatric & Adolescent Center

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Current Patient forms

Patient Forms

Current Patients if you been with us 6 Months or longer, please print the form, complete the updated form mail or return on your next visit.

(Current Patient Form)


Please print legible and bring or mail following documents:

Current Insurance information
Parient Driver’s license or government issued ID
Childs Social Security Card
Payment is expected at time of service. We accept cash, check, Visa, Master Card, American Express and Discover Card.

 
 
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