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Doctors' Pediatric - Wilton & Ridgefield Pediatrician Offices

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Dr. Rachel Priem (formerly known as Dr. Rachel Herold) is now taking new patients in our RIDGEFIELD office!!!

Unfortunately, the other providers at Doctors’ Pediatric are still only accepting parents that are expecting their first child. This is not a decision that we made lightly. We apologize for any inconvenience.

Want to join the Doctors’ Pediatric Family?

Please complete the online new patient intake form below.

Once the form has been submitted, we will confirm your insurance eligibility and contact you to review the information given and instruct you on how to transfer any prior medical records (if you are coming to us from another practice).

Please know that for us to maintain the highest standard of care, we will need to have your medical records in our office for review prior to scheduling any well visits. 

Prior to your first visit, please download the forms listed below and bring them with you when you check in for your appointment. It’s as simple as that! Welcome to our practice. We look forward to caring for your child(ren).

Family Registration Form –Downloadable PDF
Credit and Collection Policy –Downloadable PDF
Notice of Privacy Practices –Downloadable PDF
Acknowledgement of Receipt of Privacy Practices –Downloadable PDF
Medical History Questionnaire –Downloadable PDF  (please complete one for each child in your family)


 

New Patient Intake Form

On-line intake form for new families. There is also a PDF version which you can print out, complete and mail or deliver to the office. Thank you
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  • Please list their names and all dates of birth. Thank you
  • This field is for validation purposes and should be left unchanged.

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Office Locations

Wilton: 55 Danbury Road Wilton, CT 06897 (map) 203.762.3363

Ridgefield: 10 South Street Ste 206 Ridgefield, CT 06877 (map) 203.431.3363

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