New Patients
To help prepare you and your child for your first visit to Dr. Caine, you'll find all the information you need about our practice including;
- Direction and Maps
- Mission Statement
- New Patient Forms (complete this prior to your appointment to save some time)
Mission Statement
Our practice is working together to realize a shared vision of uncompromising excellence in pediatrics.
To fulfill this mission, we are committed to:
- Listening to those we are privileged to serve.
- Earn the trust and respect of patients, profession and community.
- Exceed your expectations.
- Ensure a creative, challenging and compassionate professional environment.
- Striving for continuous improvement at all levels.
Patient Forms
For your convenience, our patient forms are located below.
Please print and fill out these forms so we can expedite your first visit:
- Welcome to the Office
- Patient Registration Form
- FAQs for Patient Registration Form
- New Patient History Form
- HIPAA Receipt of Privacy Notice
- Patient Gateway Registration Form
For Initial or Followup ADHD Visits please print, complete and return the forms to the office at least one week prior to your visit
- ADHD Patient History Form
- NICHQ Initial Parent Assessment
- NICHQ Followup Parent Assessment
- NICHQ Initial Teacher Assessment
- NICHQ Followup Teacher Assessment
In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it.
Online Bill Pay
We are researching the feasibility of online bill pay services. Please check back at a later date for more information.
What to expect
Being well-prepared for the first appointment will ensure that the doctor has all of the needed information to provide the best possible care for your child. It will also help alleviate any unnecessary anxiety you or your child may be feeling prior to the first visit. Educate yourself on your child's symptoms by reviewing the content on this website. Also, take some time to review our staff page and familiarize yourself with the doctors. We look forward to your first visit.