Forms

We are excited that you have chosen Grand Traverse Children's Clinic for your child's medical care! Your comfort and convenience are our priority, and we strive to make every visit to our office a positive experience. To help you get acquainted with our office and first visit procedures, we have included helpful information on this page.


Our Mission

At Grand Traverse Children's Clinic, we promote quality medicine and compassionate care. We practice family-centered medicine, and as such, we believe that families play a vital role in promoting the health and well-being of our patients. We partner with you and encourage active participation in your child's healthcare. We realize the importance of the comprehensive needs of each child: we focus not only on physical health, but also on the emotional, developmental, and psychological needs of each patient.

Patient Forms

We are happy to provide our office forms for convenient download on your home computer. Please print and complete the forms below, and bring them with you to your child's first appointment. Questions about which forms you need? Please call our office and our courteous staff will assist you in preparing for your child's first visit.


Physical Forms Behavior Medicine Forms Authorization/Privacy Forms
  • Boy Scouts physicals
  • MHSAA Sports physicals
  • Pop Warner physicals
  • Health Appraisals
  • Vanderbilt ADHD Teacher Initial
  • Vanderbilt ADHD Parent Initial
  • Area Mental Health resources list
  • New Patient Questionnaire
  • Patient Registration Form
  • Medical Treatment auth.
  • Patient Portal Request auth.
  • Release of Information auth.
  • Release of Info - 18 yr old
  • TCAPS Medication auth.
  • Notice of Privacy Practices
  • Notice of Privacy (addendum)
  • Notice of Nondiscrimination
  • Language Taglines
  • [In order to view or print these forms you will need Adobe Acrobat Reader installed.]
    Click here to download it.

    The Initial Visit

    Our compassionate pediatricians do whatever it takes to make every visit to our office a pleasant, relaxed experience. With all of the important information about our practice available on our website, you can feel confident that you and child are well-prepared for your first appointment. We also invite you to review our staff page in order to get to know our doctors and staff. We look forward to meeting you.

    If you're preparing for your child's first visit, you can do a few things to help expedite the appointment. Please provide the following information when you arrive for your visit:

    • Insurance cards
    • Complete immunization records
    • Medical records from your previous pediatrician

    Directions

    Near Munson Medical Center in the "Professional Terrace" Building (around the back of the building).

    Our Location

    Find us on the map

    Hours of Operation

    Our Regular Schedule

    Monday:

    8:00 am-5:00 pm

    Tuesday:

    8:00 am-5:00 pm

    Wednesday:

    8:00 am-5:00 pm

    Thursday:

    8:00 am-5:00 pm

    Friday:

    8:00 am-5:00 pm

    Saturday:

    8:00 am-12:00 pm

    Sunday:

    Closed