Forms

Vaccine Information Sheets

Well visit schedule

​​​​​​​New Patients

​​​​​​​​Lead Screening

​​​​​Vaccine Information

​Vaccination Records

DelVAX Public Portal.html


​​​​​Office Forms

 Patient Registration.pdf

Release of records form.pdf

Release of records form SPANISH.pdf

Fax Release.pdf

HIPAA Privacy Policy.pdf 

DIAA 2021-2022.pdf

State of DE Child Health Appraisal Form.pdf

BOY SCOUT FORM.pdf

Revised Conner Parent.pdf

Revised Conner Teachers.pdf




In addition to caring for your children when they are sick, we also want to see them for regular well visits. Well checks focus on keeping your child healthy and are recommended at the following ages:
* 2-3 days                * 15 months              
* 1 month                * 18 months             
* 2 months               * 24 months             
* 4 months               * 30 months             
* 6 months               * 3 years                  
* 9 months               * THEN YEARLY
* 12 months      ​


​​​Vaccine Office Policy

Vaccinations can be a difficult decision for families. Choosing not to vaccinate puts some of our most vulnerable patients at risk. Therefore, effective immediately (September 12, 2022), we no longer accept unvaccinated new patients or families who plan on not vaccinating their newborn child(ren). If you have any questions regarding vaccines please call our office to speak with a nurse or discuss with your physician at your next appointment.





Click on this link for the pediatric recommended vaccination schedule: 

cdc recommended vaccine schedule.pdf



​​



​​DTaP Hib Hepatitis B Polio and Prevnar 13.pdf

Rotavirus.pdf

Hepatitis A.pdf

MMR.pdf

Varicella.pdf

Proquad.pdf

Tdap.pdf

Menactra.pdf

Trumenba.pdf

Gardasil.pdf

Influenza.pdf






Children between the ages of 9 months to 3 years of age are more likely to eat lead containing products (dirt, dust, old paint particles, etc.).  Lead exposure in early childhood is associated with developmental delay and reduced IQ, adversely affecting long-term cognitive outcomes, school performance, and social functioning.
*Lead screening tests are required by the state of Delaware at 1 and 2 years of age.






We are currently accepting new patients from birth to age 16. The following steps MUST be completed prior to scheduling an appointment.

1. Call our office at 302-633-6338 to register your child(ren) as new patient(s). 

2. We will need your child's full name, date of birth, mailing address, phone number, insurance information, bill to                information and pharmacy information. 

3. You will need to complete a patient registration (see above under office forms) and email completed form along with

    front and back of all insurance cards to office@mcpeds.com. Please note this e-mail account is not routinely                    monitored (we do not respond to emails sent to this email).

4. You will need to complete a release of record form (see above under office forms) and deliver to your current                    pediatrician. We request you have your current pediatrician either email or send a CD of your complete records                including all progress notes, immunization records, labs, consults, etc. to office@mcpeds.com. Please note this

    email account is not monitored (we do not respond to emails sent to this email).

5. You will be responsible to change your Primary Care Physician (PCP) to a physician in our group (Millcreek                      Pediatrics).

​6. Once we receive your child's complete medical records we will contact you to schedule an appointment for a routine        well visit. Please note we cannot schedule a visit until we have received your child's complete medical records.