Forms

Patient Demographic Form

 PDF

Notice of Privacy Practices (HIPAA)

 PDF

Financial Policy

 PDF

Authorization to have a patient’s protected medical records released to or from Chapin Pediatrics.

 PDF

The above forms are in a PDF format.  If you are not able to open it, you will need to download the Adobe PDF reader to do so.  This reader can be downloaded for free by clicking here: ADOBE PDF READER

Office Calendar


The Lwala Experience

Part 1

Part 2

RSS Bible Devotionals

  • God is Faithful (I Corinthians 1) February 2, 2012
    “God is faithful, through whom you were called into fellowship with His Son, Jesus Christ our Lord” (I Cor. 1:9). “Faithful” is the first Greek word in this verse. God’s faithfulness is trumpeted throughout Scripture, for God is worthy of your trust. Paul’s confidence in your salvation and sanctification is established [...] […]
  • Faithful Men (II Timothy 2) January 31, 2012
    “The things which you have heard from me in the presence of many witnesses, these entrust to faithful men, who will be able to teach others also” (II Ti. 2:2). God calls for an entrustment of His gospel from the more faithfully mature to those faithful ones desiring advance in their walk with the Lord. [...] […]
  • Fear (Matthew 10) January 26, 2012
    “Do not fear those who kill the body, but are unable to kill the soul; but rather fear Him who is able to destroy both soul and body in hell” (Mt. 10:28). Whose opinion carries the greatest weight in your life? Stephen valued Jesus’ opinion; whereas, Judas adopted the world’s opinion. [...] […]

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