Forms & Policies

Brockton Pediatrics, Inc.: Important Forms and Policies


  • It is our policy to make every attempt to schedule your appointments with your personal clinician for continuity of care.
  • We will coordinate all visits and diagnostic testing or imaging in one visit.
  • We accept a variety of managed care, PPO, HMO, and POS insurance plans, such as MassHealth Partners Health Care ACO. Please contact the office if you have questions about insurance coverage.
  • We ask that you call at least 24 hours in advance should you be unable to keep your appointment.
  • It is our policy through triage to assess your needs and schedule appointments as needed. Sick visits will be scheduled for the same day in most instances. Re-checks and Well Child Physicals will be scheduled according to the recommendations of the American Academy of Pediatrics (AAP).
  • Our clinical staff is available during regular office hours for advice on clinical issues.

During off-hours, your calls will be answered by our answering service and forwarded to either the on-call physician or our nurse triage company. You should receive a callback within 30 minutes. If you did not get a call from us, please call again to make sure your request went through.

We strongly believe in full immunization for all children in our practice

We do not accept patients who choose not to immunize their children. We follow the immunization guidelines recommended by the AAP. For information about these vaccines, the diseases they protect against, and our typical vaccination schedule, reach out to us.

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Co-pays are due on the day of service. We accept cash, checks, Visa, Master Card, and Discover.


Previous Balances and/or Deductibles

If there is a balance on your account, we will request payment by mail. However, if payment statements have been sent to you with no reply, your account will be sent to our collection agency (ACA). Our team will be happy to explain payment options should this occur.


Self-Pay Patients

If you do not have health insurance or a healthcare plan that we do not participate in, it is our policy that you must pay on the date of service. Discounts are available. Please discuss costs with us before scheduling your appointment.


Children of Divorced or Separated Parents

When children visit our office, we hold the accompanying parent or guardian responsible for any payments required regardless of the divorce decree. We cannot mediate financial disputes between the two parents. Any disputes about reimbursement for medical expenses need to be settled between the parents privately.