Preferred Contacts
Patients are encouraged to complete and return the Preferred Contacts Form but it is not required. Contactos Preferidos.
Language Services
https://www.priviahealth.com/notice-nondiscrimination/
Financial Policy
This form advises patients of their complete financial responsibility for all medical services received without regard to insurance eligibility or coverage determinations.
Authorization and Consent for Treatment Form
All patients must provide their consent for treatment, communications (calls, emails, and text messaging), and agreement of financial responsibility. Autorización y Consentimiento Para el Tratamiento.
Authorization Release Form
Allows patients to authorize the disclosure of their health information to a designated individual, company, agency, or facility.
Pediatrics in Brevard is a proud member of Privia Medical Group. The best doctors in our community have joined together to form Privia Medical Group (PMG), a multi-specialty, high-performance medical group that puts patients first. Our physicians are united by the mission of providing better, more coordinated care for their patients.
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