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Patient Visits



PURI PEDIATRIC
Medical Group, Inc.
2243 Mowry Ave., Suite F
Fremont, CA 94538

Phone
(510) 797-7766

Fax
(510) 797-0595
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New Patients
We always welcome new patients to our office. At your first time of visit please bring the following to your appointment.

Registration Form [Click here to download the form]
Immunization Card (vaccines your child has previously received)
Current Insurance Card
Correct amount of co-pay, we do accept cash, check, or credit
Please check your eligibility with your insurance before time of visit
Guarantor information [Click here to download the form]
Immunization Schedule [www.aap.org]


Sick Patients
At the time of your sick or recheck visit please bring your updated insurance card, correct amount co-pay, and guarantor information.

Guarantor information [Click here to download the form]


Well-Care or Healthy Check-ups
At your well-child or healthy check-ups please bring your current insurance card, immunization record (shot record), correct amount of co-pay, guarantor information, and any forms that need to be filled out to your appointment.

Guarantor information [Click here to download the form]
Immunization Schedule [www.aap.org]


School/Daycare Forms
School or daycare forms need to be brought in at the time of your appointment to be filled out. Any forms that are not brought at time of visit will include an extra charge.


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