Raising the Standard in Pediatric Care

Patient Info

Welcome to Harmony Pediatrics of North Jersey!

For new patients there is information about our practice which can be printed out and brought with you at your first visit.

For our established patients there are copies of forms for a variety of situations including school physicals. Preprinting some of these may be helpful.

Bear in mind that we will upload a copy of your child’s Universal Child Health Care Record or the Eligibility page of the Athletic Pre-Participation Physical Examination Form which have been prepopulated with much of your information, at every physical exam.

My Kid’s Chart

Please call our office to sign up for My Kid’s Chart, or inquire at your next visit.

Immunizations, school and camp forms, and more will be available for you to download at home at your convenience. Additional information may be accessed upon request.

There is a secure messaging feature which will allow you to send non-urgent messages to the office and doctors. Messages will be checked frequently and in most cases replies will be given within 2 business days. Files such as forms and pictures may be uploaded to us. Completed forms and other information may then be downloaded through the portal.

Once registered you can bookmark the url, save it to your smartphone, or use the Patient Portal button on the top of each page of our web site. Please read the Terms and Conditions on the sign-up page.

We value our patient’s privacy. Access to patient information is turned off on the patient’s 18th birthday. Of course, those patients may register for their own accounts as well. In addition, they may authorize their parents to have access to their records by filling out the Parental Authorization Form. For complete instructions on using My Kids Chart download the My Kid’s Chart Users Manual.

New Patients

Information for New and Prospective Patients is outlined below.

Brochures

Practice Brochure
HIPAA Privacy Notice
Your Health Plan Coverage and Our Financial Policies
BCD Financial Policies Page

Prior to your first visit, we would like you to complete new patient forms so that we may obtain all previous records you or your child may have.

Should you have any questions about this process, please contact our office manager at 201-666-1001. It would be helpful if you downloaded and filled out the Record Request form.

New Patient Packet

The new patient packet includes the following information. Please print out and complete these forms prior to arrival

** Please do not sign this form until you have read all the sections of the Financial Policy above.

Current Patients

School Forms

The NJ Universal Child Health Care Record will be provided for Grades K through 5 .
Athletic Pre-Participation Physical Examination, History Form
Please print out and complete this History form before you bring your child for a physical exam. The Physical and Eligibility Forms will be provided.
The New York Health Certificate and Appraisal will be provided. Most NYS schools accept the NJ form, but you may bring this if yours does not.