Patient Forms

We are excited that you have chosen Gadsden Pediatric Clinic and Rainbow Pediatrics 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.

To understand what to expect for your child's first visit to our practice, please read through this page.

Our Mission

Our practice is working together to build life-long relationships between our staff and our patients by consistently providing our patients with compassion, excellence and value. To fulfill this mission, we are committed to:

  • Improving the lives of the children we serve by providing quality care in a child-centered environment.
  • Listening to our young patients and their families who we are privileged to serve.
  • Guiding our patients along a path of optimal health and wellness.
  • Continually pursuing excellence at all levels through continuing education.

Well Visit Schedule

Gadsden Pediatric Clinic follows the routine office visit schedule as recommended by the American Academy of Pediatrics. Well child check-ups are important for maintaining good health and for detection and prevention of illness and developmental problems. Immunizations will be given at appropriate visits according to a schedule approved by the Advisory Committee on Immunizations Practices and the American Academy of Pediatrics. We recommend well child visits at the ages listed in the chart below.

Infants & Toddlers Preschool School Age
1 week 2 years 6 years
4 weeks 3 years 8 years
2 months 4 years 10 years
4 months 5 years 12 years
6 months 14 years
9 months 16 years
12 months 18 years
15 months
18 months

What to bring to your first visit?

We work hard to ensure that your child receives prompt medical care in a comfortable, child-friendly office setting. To help expedite the first appointment, we ask that you please bring your child's immunization records and be prepared to complete paperwork regarding your family medical history, your child's medical history, and insurance information.

Patient Forms

We are also happy to offer you the option to download, print and complete our office forms to reduce wait times during your first appointment.

Patient Information
Parent Delegation Form
Notice of Privacy Brochure
Financial Policy
Vaccine Policy
Medicaid Policy

In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it.

What to Expect

On the day of your child's first visit to our office, we recommend arriving a few minutes early. This allows extra time for finishing up any registration forms and ensures you have plenty of time to get acquainted with our staff and office. We look forward to meeting you and joining with you to help your child maintain optimal health.


Our Location

Find us on the map

View the KidsDoc Symptom Checker from HealthyChildren.org

Choosing a pediatrician is an important and personal decision and we want you to feel at ease with the care you and your child will receive.

An online resource center providing you with additional helpful information.

Questions or Comments?
We encourage you to contact us whenever you have an interest about our services.

Call 256-543-2894

501 Bay Street,
Gadsden, AL 35901