New Patient Forms

New Patient Registration

Become a patient today!

Click each link to complete the HIPAA-compliant forms below.

All of the documents below must be completed to schedule an appointment.

***Please submit your child/children's vaccination records PRIOR to your appointment***

You can email them to hello@nxtsteppeds.com

(If you have any questions call us at (469)447-8730)

  1. Patient Demographic Form
  2. Child Health History
  3. Patient Responsibility/Financial Agreement
  4. Consent to Treat & Prescription Policy
  5. HIPAA Form & Privacy Notice
  6. Wellness Care ACA
  7. Medical Release Form