ADC Pediatrics
Patient Forms

Save time and complete your form ahead of time.  Just print the forms below, complete and bring to your visit.

Pediatric New Patient Form (PDF)

Prenatal Questionnaire (PDF)  (Word)

Medical Records

To transfer your records to our office, please download the
Medical Records Release Form (PDF) (Word) below.

School Physical Forms 2008-2009

Austin ISD (PDF)

Leander ISD (PDF)

Pflugerville ISD (PDF)

Round Rock ISD (PDF)


Click here to download Adobe Acrobat Reader for PDF forms.
The Austin Diagnostic Clinic, A Multi-Specialty Medical Clinic
 12221 MoPac Expressway North | Austin, TX 78758 | 512.901.1111
Serving the communities of Austin, Round Rock, Pflugerville, and Central Texas since 1952
Allergy & Immunology | Audiology | Cardiology | Dermatology | Diabetes Management Center | EasyCare Clinic
Endocrinology | Family Practice | Gastroenterology | Health Risk Management | Hematology/Oncology
Imaging Center | Internal Medicine | Menopause Center | Nephrology | Neurology | Nuclear Medicine
Obstetrics/Gynecology | Ophthalmology | Optical Shop | Orthopedic Surgery | Otolaryngology
Outpatient Surgery Center | Pediatrics | Physical Medicine | Podiatry | Pulmonary Disease | Radiology 
Rehabilitation Services | Rheumatology | Surgery | Travel Clinic | Urgent Care Clinic | Urology | Site Map

This website and its contents may not be reproduced in whole or in part without written permission.  The Austin Diagnostic
Clinic and its associated logo are registered State of Texas trademarks and may not be used without written permission.