New Patient Application
This form does not guarantee an appointment
This form is submitted to BrightStarts Pediatrics before an appointment is made. Only after the form is complete and reviewed by BrightStarts staff, and the decision is made to accept the patient, then will someone call to notify the patient’s guardian of the office’s decision and schedule an appointment within the next two weeks if applicable.
All new patients must sign that they are willing to give their child the school-required vaccines per Alabama, at minimum.