Forms & Documents

Accepting New Patients!

 Discover if Pirate Pediatrics is a good fit for you. If you would like to join our family, submit a new patient interest form to get started.

If you’re expecting, we'll show you around and answer your questions.

Experience healthcare beyond the ordinary

We provide personalized healthcare care for children while supporting parents to be their best.

Streamline your first visit by completing the New Patient Orientation Guide at home. With paperwork out of the way, you can focus entirely on your child. Bring it with you for a more convenient experience.

Welcome aboard!

Your Journey with Pirate Pediatrics Begins Here

Welcoming New Patients: 

Postpartum Questionnaire




Modified Checklist for Autism in Toddlers


We'll notify you through My Kid's Chart patient portal,  to complete your visit forms online via CHADIS . If you prefer paper copies, they are available in the links below.

Completing forms 24 hours in advance prevents appointment rescheduling.

Completing Forms Hassle Free

Preparing for Your Visit: 

School Forms Made Easy:

For prompt assistance, complete the parent section of forms.  Completed forms will be available on My Kid's Chart patient portal within five business days. 

Fees may apply for form completion; refer to  our form policy for details.

A Parent’s Stress-Free Approach

Schools may ask for various forms, and we want to make sure you have what you need, when you need it!

Complete for first-time enrollment in NC public school.