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Holland Pediatric Associates (also goes by Holland Pediatrics)

926 Washington Ave Holland, MI 49423

Patient Portal

Call Now: (616) 393-0166

  • Home
  • About
    • Providers
  • Policies
    • HIPAA Policy
    • Financial Policy
    • Missed Appointment & Late Cancel Policies
    • After-Hours On-Call Physician Billing Policy
    • Other Office Policies
  • Forms
  • New Patient Information
    • New Patient Forms
  • Health Information
    • Vaccines
    • Common Issues
    • Urgent Symptoms
    • Symptom Checker
    • Newborn Concerns
    • Just For Teens
    • Reliable Pediatric Resources
    • Acetaminophen & Ibuprofen Dosage Charts
  • Well Child Visits
  • Blog
    • Health Tips
  • Contact

Forms

Forms

Patient Forms

  • Welcome to HPA!
  • Caregiver Consent Form
  • Consent for Notifications
  • Financial Policy
  • Medical History
  • Missed Appointment Policy
  • Patient Information Sheet
  • Vaccine Policy
  • After-Hours On-Call Physician Billing Policy


  • ¡Bienvenido a HPA!
  • Formulario de Consentimiento del Cuidador
  • Consentimiento para Dejar Mensajes de Correo de Voz y Notificaciones
  • Póliza Financiera
  • Formulario de Historial Médico
  • Políticas de Citas Perdidas y Cancelación Tardía
  • Hoja de Información para el Paciente de Menores
  • Política de Vacunas   
  • Política de Facturación de Médicos de Guardia Fuera del Horario de Atención

Records Release Forms

  • Records Release Form to HPA
  • Records Release Form from HPA       
  • Formulario de Liberación de Registros a HPA
  • Formulario de Liberación de Registros de HPA

Sports Physical Form and Other School Forms

  • Sports Physical Form
  • Health Appraisal Form
  • Preschool Application
  • Forma Física Deportiva              
  • Formulario de Evaluación de la Salud         
  • Solicitud Preescolar
Holland Pediatric Associates (also goes by Holland Pediatrics)

Quick Links

  • Home
  • About
  • Providers
  • Urgent Symptoms
  • Health Information
  • Common Issues
  • Newborn Concerns
  • Reliable Pediatric Resources
  • Well Child Visits
  • New Patient Information
  • Contact

Contact Information

Phone: (616) 393-0166

Address: 926 Washington Ave., Building  C

Holland, Michigan 49423

Office Hours

Monday-Thursday 8:00 am-12:00 pm & 1:00 pm-5:00 pm with EVENING APPOINTMENTS usually available until 8:00 pm

Friday 8:00 am-12:00 pm & 1:00 pm-5:00 pm

Patient Portal

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