Online Registration

Welcome! You have returned to the PediaClinic website where you will securely register members of your family before your visit. You will have to repeat a few tidbits of information. Relax…This won’t hurt a bit…but you’ll need your insurance card.

Your Child's Symptoms
Parent/Guardian Information
Other Parent/Guardian/Contact
Patient Information
Insurance for Child
Other Information
Federal guidelines mandate that we ask for information regarding race and ethnicity according to federal definitions so that we may be able to deliver the most appropriate health care to your family and reduce inequalities in certain groups. This field is voluntary and if you prefer not to answer, simply select "Decline to answer”.
While we may not be in a position to provide services in all preferred languages, we are asked to collect this information in order to identify potential needs for our patient population.
How should we reach you?
Please indicate "No Contact" if someone else has been designated to receive this information.
Other Children
As long as you are here….feel free to enter your other child’s information


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We're Here For You...

  • Fevers
  • Coughs
  • Colds
  • Flu
  • Earaches
  • Sore Throat

Need An X-Ray?

We don't have x-ray available at this time but can see most bumps, bruiss and sprains.  We'll make arrangements for an x-ray nearby if we deem it to be necessary.