Los Alamos Pediatric Clinic

Here are the forms for Dr. Krohn's office.


You may print them out, fill them in and bring them into your apointment,

OR

You may save them to your computer, fill them in by typing into the fields and bring them into your apointment.

Financial Policy pdf link

Financial Policy Form
Patient Form pdf link

Patient Information Form
HIPPA pdf form link

HIPPA Form
HIPPA pdf form link

Records Release Form
Contract for teen drivers pdf link

Contract for teen drivers Form