1508 South Gary Place, Tulsa, OK, USA

Phone 918-960-2006

Phone 918-960-2006

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    • Home
    • New Patient
    • Location
    • Payment
    • About Us
    • Forms
    • Education
  • Home
  • New Patient
  • Location
  • Payment
  • About Us
  • Forms
  • Education

Midtown Pediatrics

Midtown PediatricsMidtown PediatricsMidtown Pediatrics

Charity Pollak MD Pediatrician

Charity Pollak MD PediatricianCharity Pollak MD Pediatrician

patient forms

ADHD FORMS

Parent vanderbilt form
Teacher vanderbilt form

AUTHORIZE OTHERS TO BRING YOUR CHILD

Authorization to treat form

NEW PATIENT FORMS

HIPPA
Registration FORM
History FORM
No-Show Policy

RECORDS RELEASE

Medical records release form

SPORTS PHYSICAL

OSSAA Sports PHYsical form

Midtown Pediatrics Data Privacy Policy (pdf)

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