Forms can be completed online through the patient portal or you can print them from our website and bring them with you to your appointment.
"Dr. Mindy Maggid always spends a good amount of time with each of our children during their annual visits. We like the way she talks to the children, and our children absolutely love her!"
"Dr. Maggid is an amazing Doctor. She sees both my boys since birth and even though I no longer live in the area I have kept her as their Doctor. She cares, she is gentle and always makes us feel like a priority. She has given us personal calls to check on them after high fevers, or really bad colds to make sure treatments are working. The other doctors are just as professional and the on- call is quick no matter what time of the night."
"My three children have gone to Dr. Plotsky their whole life. And they are now 21, 19 and 17. We have dealt with many childhood issues, some typical and some not so typical. Dr. Plotsky and the whole team are simply wonderful; they view all aspect of the child - health, social, educational, safety, diet, exercise. They are excellent doctors and they care."
"Carol Plotsky has always treated me as a partner in the health of my children. She listens to what I tell her (and listens to my children). When my third child was born with a rare disease she quite literally saved his life. Couldn't find a better pediatrician."
"Dr. Burgett has been our pediatrician for the past 14+ years for both daughters. She has a wonderful manner, talks to the children and explains what she is doing, has called us on her own time to check on one of our girls who had major issue. Listens well to patient and parent. Love the staff at the office too. They are very busy and try hard to accommodate urgent care needs as well as getting health forms."
"They have taken care of our family with exceptional care. We met them prior to the birth of our first child 13 years ago. We now have 4 children Since then they have helped us with innumerous big and little complications of life. We can't recommend them highly enough."
"Shady Grove Pediatrics and Dr. Plotsky and Dr. Burgett are great at what they do. They instill confidence in diagnoses and are great with the kids from babies to teens. Yes, I've been with Dr. Burgett for 17 years and with SGPA for 14. They trust mom's instincts and follow up beautifully. You won't regret seeing these doctors."
Patient Forms
Authorization for Release of Medical Information (PDF) - Allows patients to authorize the disclosure of their health information to a designated individual, company, agency, or facility. Autorización De HIPAA Para Divulgar Información Del Paciente
Authorization and Consent for Treatment (PDF) - All patients must provide their consent for treatment, communications (calls, emails, and text messaging), and agreement of financial responsibility. Autorización y Consentimiento Para el Tratamiento
Preferred Contacts (PDF) - Patients are encouraged to complete and return the Preferred Contacts Form but it is not required. Contactos Preferidos
Virtual Visit Policy (PDF) - This policy describes the process for the documentation, maintenance, and transmission of information using virtual visit technology.
Office Policies
Financial Policy (PDF) - This form advises patients of their complete financial responsibility for all medical services received without regard to insurance eligibility or coverage determinations. Política Financiera (PDF)
Notice of Privacy Practices (PDF) - Describes how health information about you (as a patient of this Care Center) may be used and disclosed, and how you can get access to your individually identifiable health information. Please review this notice carefully. Aviso de prácticas de privacidad (PDF)
*SGPA owns the right to change or waive the fees listed in the policies above.
