Vaccine & NSP Policies

Please click here to see our Notice of Privacy Practices.

We think clear communication is key to a good relationship. So you won’t have any surprises, we’ve prepared a statement of Practice Policies that we’ll ask you to sign during check-in. Most of the information concerns our approach to permissions, financial charges, and appointment procedures. Please read these policies, so we can all be on the same page. We’ve done everything we can to keep them short!

• Your current address, telephone number and insurance information will be requested at each visit. If current insurance cannot be verified, or if a Northside Pediatrics Physician is not listed as the primary provider for your child, we will require payment in full for services rendered.
• If your managed care plan requires a PCP (primary care provider) referral in order to see a subspecialist, a referral request must be completed in advance of your appointment. Our office requires 72-hours' notice to process the referral request.
• All co-payments are due at the time of service, as per our contract with your insurance carrier. Failure to pay a co-payment will result in a $25 billing fee.
• Well-check appointments require a 24-hour cancellation notice. Sick appointments require a 2-hour cancellation notice. Cancellation notices given within less than the requested time will result in a $50 cancellation fee.
• Written and verbal information will be provided at each visit where vaccines are administered, and verbal consent will be requested prior to administering any vaccine.
• If verbal consent is provided and later withdrawn after vaccine doses have been prepared for your child, the full cost of vaccines will be billed.
• Some laboratory charges may be provided by Quest Diagnostics or LabCorp, which are contracted outside labs.
• All medical-records requests must be in writing and received in our office 7-10 days prior to the date needed. Records can be mailed or faxed, and all medical-records requests will have a fee based on the number of pages. This includes camp forms, immunizations, etc.
• A Health/Immunization form will be provided at the time of your child’s well check-up at no charge. Replacement forms will be provided at a charge of $10. Other forms (camp, school, sports, etc) completed at the time of a check-up appointment are also provided at no charge. Forms completed for your child at any other time will incur a charge of $10 per patient for up to three forms, $15 for up to 3 forms per family, and $20 for a STAT request for individual form. Routine forms will be returned within 7-10 business days and STAT forms within 72 hours.
• If you have an insurance we contract with, we will gladly file your visit to your carrier. However, you are ultimately responsible for any unpaid balance on your account.
• You understand and agree that in the event of default in paying a patient-due balance, you will be responsible for reasonable collection charges and/or court costs and attorney fees.

At Northside Pediatrics, the health and well-being of your child is our top priority. We are committed to practicing medicine in compliance with the evidence-based practices established by the American Academy of Pediatrics, so we can provide the best care for your child.

• For the safety of the community and our patient population, Northside Pediatrics requires that our patients be vaccinated according to the American Academy of Pediatric's recommended immunization schedule. We do not offer alternate vaccine schedules; so we do not skip, defer, or split any vaccines unless medically contraindicated.
• We firmly believe in the effectiveness of vaccines to prevent serious illness and to save lives. 
• We firmly believe in the safety of vaccines.
• We firmly believe that all children and young adults should receive all of the recommended vaccines according to the schedule published by the American Academy of Pediatrics.
• We firmly believe, based on all available literature, evidence, and current studies, that vaccines do not cause autism or other developmental disabilities.
• We firmly believe that thimerosal, a preservative that has been in vaccines for decades and remains in some vaccines, does not cause autism or other developmental disabilities.
• We firmly believe that vaccinating children and young adults may be the single most important health-promoting intervention we perform as health care providers, and that you can perform as parents/ caregivers.
• Our goal is to help parents understand the importance of vaccines, and to avoid the possibility of medical complications or death of their child due to vaccine preventable illness. Because of the recent increase in underimmunization, there have been outbreaks of and deaths from measles, Haemophilus and pertussis right here in Atlanta. We will work with any family whose child is not up to date with vaccines to become compliant with current recommendations. We will also gladly answer questions or address any concerns regarding vaccines during your visit.
• We understand that some parents may refuse to vaccinate their children despite our efforts to provide them with accurate medical and scientific data. While we respect a parent’s personal beliefs and decision-making rights for their child, we feel that you are putting your child at unnecessary risk for life-threatening illness, disability, or even death- and we cannot assume medical liability for your choices. Therefore, parents who refuse to vaccinate according to the recommended schedule will be asked to find another health care provider that shares your views.

Just like you, our top priority at Northside Pediatrics is keeping your child safe, healthy and thriving. We understand that deciding how to best protect your child's health is one of the most important parenting decisions you’ll make. As medical professionals, we feel very strongly that vaccinating children on schedule with currently available vaccines is absolutely the right thing to do for all children and young adults. Please be advised that delaying or spreading out the vaccines to give one or two at a time over multiple visits goes against expert recommendations, can put your child at risk for serious illness, disability, and even death, and goes against our medical advice as providers at Northside Pediatrics.

We are making you aware of these facts not to scare you or coerce you, but to emphasize the importance of vaccinating your child. We are more than willing to discuss any questions you may have about vaccines, but we do require all current and new patients to adhere to the vaccination schedule endorsed by the American Academy of Pediatrics. By following this policy, we aim to ensure that every child in our care has the opportunity to grow up healthy, safe, and protected against preventable diseases.