Dr. O and her staff at Pediatric Associates of Jacksonville warmly welcome your children as new patients!

Below are several forms that you can download, complete and bring with you to your appointment. Or you may fax completed forms to the office you are visiting:

New Patient Registration
Newborn Registration Form or complete it online
Patient Health Form
Medical Records Release Form
HIPAA Brief Privacy Notice

Ponte Vedra Beach Office: fax – 904-273-6532
Sutton Park Office: fax – 904-743-1759
Racetrack Rd. Office: fax – 904-460-2212


MOST INSURANCE PLANS are accepted for your convenience, with the exception of Medicare and Medicaid. Please remember that your insurance is an agreement between you and your insurance company. We file your insurance as a courtesy to you, but you are responsible for all communications with your insurance company concerning benefits, what is covered and not covered, and what you are financially responsible for.

NOTE: If your child has no insurance coverage, you may qualify for Florida Kidcare – affordable insurance coverage offered through the State of Florida. For more information go to www.floridakidcare.org.

Payment Policies

Pediatric Associates of Jacksonville gladly accepts most major credit cards and debit cards as payment for services rendered. We ask that the person bringing the child in for their appointment pay the applicable charge at the time services are rendered.


To ensure we respect the time of all of our patients, we kindly ask that you bring your child to his/her appointment on time. Patients more than 15 minutes late may be asked to reschedule. We ask that you give us at least 24 hours notice if you need to cancel your appointment to avoid a $35.00 late cancellation charge.