Pediatric Patient Registration Forms in Tampa, FL

Check-in or Bring in a Completed Registration Form to Expedite Your Visit. For More Information Call (813) 984-8846.

Thank you for choosing Julia Barriga M.D. P.A. Pediatric Clinic. Please click below to complete the “Patient Registration form”. All patients are served as they arrive.

PATIENT NON-DISCRIMINATION POLICY

 JULIA BARRIGA, MD., PA. will not discriminate in the provision of health care services to an individual:

1. Because the individual is unable to pay for the health care services;

2. Because payment for those services would be made under Medicare, Medicaid, or the Children’s Health Insurance Program (CHIP); or

3. Based upon the individual’s race, color, sex, age, national origin, disability, religion, gender identity or sexual orientation.

Office Policy

Vaccine Policy

13 Year and Older Privacy Policy

Authorization for Treatment

Patient Portal User Agreement

Patient/ Family update information

Insurance Information

Newborn To 3yo New Patient Package Forms

4 Years And Older New Patient Package Forms

Sports Physical Forms

Sliding Fee Forms