New Patient Checklist
*If you just submitted your form, you’re all set — we’ll contact you shortly.*
New here? Please start with our new patient consultation form.
Required Documents
- Valid Drivers License or photo ID of Parent/Guardian
- Insurance card (Photo, copy, or email accepted)
Insurance Information:
For details on accepted insurance plans and coverage, click here.
Note for Georgia Patients:
Due to state-specific insurance policies,
Georgia patients must have Dr. Yvrose Valcourt or Valcourt Pediatrics listed as their Primary Care Provider (PCP) before being seen.
Patient Forms & Appointment Info
Patient Forms (English and Spanish):
All new patients must complete our New Patient Forms prior to their visit. These can be submitted online or brought to the office.
- Click to open the form below.
- Fill out directly on your device.
- Save the completed form to your phone or computer
- Email it to admin@valcourtpediatrics.com
— or —
Bring a printed copy to your appointment.
At Check-In:
- Present your photo ID, insurance card, and copay (if required)
- Arrive 15 minutes early to allow time for verification and processing
Disclaimer:
All patients are required to comply with our intake procedures and office policies. Submission of forms does not guarantee an appointment until confirmed by our staff.
Cash Basis Patients:
We accept patients on a cash basis. Please contact our office for pricing and payment options.
Out-of-State Patients:
If you are coming from outside of Georgia or South Carolina, please bring a copy of your child’s immunization records. We accept records in any format (paper or digital).