New Patient Packet

If you want to transfer your child's care to or from East Elm Pediatrics, please complete this form and return it to our office.
Once your child turns eighteen, they must complete an Adult Demographic Sheet. This demographic sheet replaces the one you filled out for them as a minor. Please bring it to the office as soon as possible.
If you would like to submit photographs of your family to be displayed on the Homepage of our website, please complete this consent form and return it to our office. Photographs for consideration can be emailed to Helen at

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News @ East Elm

  • Patient Portal Is Now Open!

    The Patient Portal allows you secure, convenient communication with our office, 24/7.
  • Pay Your Bill Online!

    Did you know you can now quickly and easily pay your bill online?
  • Visit Our Facebook Page!

    East Elm Pediatrics is now on Facebook! Please follow the link to like, follow, and share our page.
  • Monthly Staff Meetings

    East Elm Pediatrics holds monthly staff meetings on the first Wednesday of every month. On these Wednesdays, our office will remain open until 8:00 pm, but from 5:00 - 7:00 pm we will only see Walk-In/Urgent Care patients.
  • Homepage Patient Portraits

    The pictures on our Homepage feature our own patients!
  • Pediatric Urgent Care!

    Happy New Year! We now have extended office hours and Pediatric Urgent Care!