Pediatrics Associates of Orlando

All requests will be considered within 5 business days.

Please be aware that there is a $5 charge if you are requesting duplicate HRS forms.

For more information, please contact us at

Pediatric Associates of Orlando, P.A.
414 North Mills Avenue
Orlando, FL 32803
Phone: (407) 841-7290
Fax: (407) 841-0814

Patient Name:
Date of Birth:
Additional Children?
Patient Name:
Date of Birth:
Patient Name:
Date of Birth:
Patient Name:
Date of Birth:
Patient Name:
Date of Birth:
Contact Number:
Email:
Parent Name:
Date of your child's physical
(within the last year):
Office Preferred:
Are your child's immunizations up-to-date?
- If yes, submit request.
- If no request an appointment

Pediatric Associates of Orlando offers and maintains this web site to provide information of a general nature about the conditions requiring the services of a pediatrician. The information is provided with the understanding that Pediatric Associates of Orlando is not engaged in rendering medical advice or recommendations. Any information in the publications, messages, postings, or articles on this web site should not be considered a substitute for consultation with a board certified pediatrician. | Privacy policy

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