Online Help Desk

A. Forms for New Patients to complete

B. Insurance plans accepted

C. Hospital affiliations

D. Office Hours, Office Visits, Office Procedures, Cancelling Appointments

E. Pay My Bill

A. Forms for New Patients to complete.

Information provided by the numbered links on this page to 4 required forms is in .PDF files that you can download, read and/or print by using the FREE Adobe Acrobat Reader that must first be installed on your computer. 

*If you don't have the FREE Adobe Acrobat Reader installed,

CLICK the Get Adobe Reader® stamp below:

TIME-SAVING TIP for both you and our office staff

→ Download, print and try to complete all 5 required New Patient forms at home, and when you visit our office, bring with you all forms that you have tried to complete.

New Patients please CLICK on each of the links below for 5 REQUIRED forms you must complete:

1. Child's Initial History Questionnaire - (one for each child)

2.  Patient Acknowledgement of Children's Clinic of Wyomissing Policy for the Protection of Identity Theft Red Flag Law & Patient Consent for Use and Disclosure of Protected Health Information

3.  Transfer & Copy of Records -REQUEST FOR RELEASE OF MEDICAL INFORMATION - FROM CCW to another medical office- with Fees

4.  Transfer & Copy of Records -REQUEST FOR RELEASE OF MEDICAL INFORMATION - TO CCW from another medical office

5.  CCW Financial Policy

New Patients: To shorten the length of your office visit, if possible, please complete and bring each of the 5 above required forms with you.

The staff at Children's Clinic thanks you!

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B. Insurance plans Accepted

Questions? Please contact our billing department at (610) 376-5341.

1.If your particular Insurance plan is not listed below,

please call our billing department for additional information.

2.If your insurance will be changing to a carrier that CCW does not currently participate with, please let us know so we can try to accommodate your needs.

Thank you.
 

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C. Hospital affiliations

The Reading Hospital and Medical Center

St. Joseph Medical Center

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