Patient Forms

New Patient Forms

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New Patient Welcome Packet

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Consent To Treat

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Patient Responsibility Form

General Forms

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Notice of Privacy Practices

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Privacy Policy Statement

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Security Policy Statement

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Consent To Treat

Helpful Charts

Location & Hours

15290 Summit Avenue
Suite B
Fontana, CA 92336

Phone: (909) 225-1900
Fax:     (909) 663-9070
Email: goldstarpedsfontana@outlook.com

Office Hours:
Mon Wed Fri 8:00am – 5:00pm
Tues Thurs   9:00am – 6:00pm