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Patient Info

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Patient

Forms

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Patient

Resources

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pediatric general surgeon - paperwork

Before

Surgery

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Insurance &
Billing

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After

Surgery

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Medical

Records

Patient Forms

In an effort to make each appointment go as smoothly as possible, we ask that you complete relevant patient forms prior to your child’s visit. To save time in the office, feel free to print and complete the patient forms and bring them with you to the appointment. 

 

If you have any questions about the information on these forms or about your appointment in general, please call (512) 708-1234.

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Patient Forms

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Consent Without Guardian

​​Formas del Pacientes- Español

 

Descargue los siguientes formularios, complételos y tráigalos a la oficina para su cita.

Before Surgery

We’re here to ensure your child’s surgery is as smooth and stress-free as possible. Preparing together can help ease anxieties and create a positive experience. Prior to your child’s surgery, please fill out any required patient forms.
 

Steps to Prepare:
 

  • Ask Questions: Speak with your physician or hospital staff ahead of time to address any questions you might have. 
     

  • Be Honest: Use simple, age-appropriate explanations with your child about the procedure and what to expect. 
     

  • Encourage Play: Let your child explore with medical toys or dolls to build familiarity with their procedure, express their feelings and feel more in control. 
     

  • Pack Comfort Items: Include favorite toys, books or a cozy blanket to help them feel at ease. 
     

  • Storytime Prep: Read books like Curious George Goes to the Hospital or other relevant books and stories to help your child feel more at ease.

 

For more information about our surgical facilities, visit:

 

 

pediatric trauma surgeon

Pre-Operative Tours at Dell Children's Medical Center
 

Prepare your child for surgery with a hands-on pre-operative tour led by a Child Life Specialist. These tours help children and families understand what to expect, reducing stress and promoting confidence. Your child will get to see medical equipment, explore key areas like the operating and recovery rooms, and learn about the surgery process in a kid-friendly way.
 

Siblings are welcome to join, making it a family experience. For dates, times and reservations, call the Surgery Child Life Specialist at (512) 324-0146.

After Surgery

Your child’s recovery is our priority, and we’re here to help every step of the way. If you have any questions or concerns about post-operative care, we encourage you to contact us directly. Our team is available to answer your questions and ensure your child’s recovery goes as smoothly as possible.
 

For assistance, please call us anytime at (512) 708-1234. We’re here to provide the guidance and support you need.

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Patient Resources

For additional information regarding our professional associations, resources, and partners, please see the links provided below.
 

Insurance & Billing

At Austin Pediatric Surgery, we are committed to ensuring that every child receives the surgical care they need, regardless of insurance status. We accept all major insurance plans and encourage families to contact us with any questions about coverage or financial arrangements. Our team works closely with families to make the process as smooth as possible and will assist in finding solutions that fit your situation.

If you have questions, please call our office at (512) 708-1234 to speak with our financial department.

Medical Records Request

All patient health care information at Austin Pediatric Surgery is strictly confidential. Therefore, medical records cannot be released to any person or organization without the consent of the patient or the patient’s legally authorized representative (unless authorized by law).

Release Form

To receive a copy of your child’s health information, an authorization to release medical information must be signed and dated by the parent or legal guardian. A fee of $25.00 will be assessed to cover the cost of copying and sending your record. If the records are being faxed or mailed to another medical facility, there is no charge.

Submitting your Form

Completed authorization forms may be submitted to Austin Pediatric Surgery by mail, in person or by fax.


Mailing address:
Austin Pediatric Surgery
1301 Barbara Jordan Blvd Suite 400
Austin, TX 78723

Fax number:
(512) 708-4567

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