Effective January 1st, 2024


Daycare, Pre-School, Camp, Sports Physicals, and other activity forms:

Completed during a visit = No Cost and forms completed the same day

Completed outside of a visit = $5.00 p/p up to a maximum of $25 AND will require up to (3) three business days for completion

FMLA, Disability, etc. forms:

$25 prepaid form fee required before completion

AND will also require up to (3) three business days for completion.

Please understand that some forms are more complicated and may require an appointment with your provider to be completed, this is based on the discretion of the provider.  Should an appointment be required there will be no additional fees for form completion.

It is your responsibility to provide any forms needing to be filled out to our office with adequate notice. Your child will need to be up to date on their yearly wellness exams.

If your insurance does not cover annual preventative visits, please call our office to discuss options.


Thank you,
Peacock Pediatrics