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Patient forms

Please fill out the following Patient Forms prior to your appointment. For your convenience we have also provided the patient forms in Spanish.

English Forms

  • New Patient Form
  • 9, 12, and 15 month old check up form
  • 18 month old check up form
  • 2 and 2.5 year old check up form
  • 3 year old check up form
  • 4 to 7 year old check up form
  • 8 to 10 year old check up form
  • 11 to 14 year old check up form
  • 15 to 17 year old check up form
  • 18 to 21 year old check up form
  • Initial conner forms for teachers and parents
  • Follow up conner forms for teachers and parents
  • Medical record release forms
  • Sports Physical clearance forms

Spanish Forms

  • Forma de nuevo paciente
  • Forma para pacientes de 9, 12, y 15 meses
  • Forma para pacientes de 18 meses
  • Forma para pacientes de 2 y 2.5 años
  • Forma para pacientes de 3 años
  • Forma para pacientes de 4 a 7 años
  • Forma para pacientes de 8 a 10 años
  • Forma para pacientes de 11 a 14 años
  • Forma para pacientes de 15 a 17 años
  • Forma para pacientes de 18 a 21 años

ABOUT COVINGTON PEDIATRICS

Known for her compassionate and thoughtful patient care, Dr Juliana Nahas and her team use conventional and functional medical knowledge to treat diverse symptoms and conditions in children and teenagers. In addition to conventional pediatric care,she offers the functional medical evaluation, for those interested in that service, including specialized blood, stool, saliva and urine tests, and utilizes nutrition, supplementation, lifestyle recommendations as well as prescription medications to treat a host of conditions and problems.

Our unique approach to diagnosing and treating diseases and disorders recognizes that lasting health depends on resolution of the root causes of your disease.Click here to learn more »

Unique Approach

One of the unique aspects of Covington Pediatrics is our belief in “food as medicine”. Our approach also includes teaching you how to heal the gut, fill in nutritional deficiencies, and how to use functional nutrition to heal chronic illness.
Click here to learn more about our approach with Dr. Juliana Nahas

Your Next Steps

After you have watched our feature presentation about our approach to functional medicine, we'd love to hear from you - to answer your toughest questions.

Simply call to schedule a consultation with our patient coordinator at 770-787-7444.

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