Downloadable forms
- New patient registration
- Authorization for the release of medical information and records
- Financial policy
- Policy for children whose parents are separated or divorced
- Referrals and authorizations policy**
MyChart forms
- MyChart adult proxy access consent form* (*needs to be submitted in person by adult patient)
- MyChart billing
- MyChart registration
*Please submit completed forms by uploading to MyChart, faxing to 781-863-2007 or emailing to info@lexpeds.com*
**However, referral authorization policy forms can be emailed to mpescatore@lexpeds.com