Find a Medical Practice (BJC Medical Group of Missouri and Illinois)

636.344.2213

Fax: 636.344.2214

20 Progress Point Parkway
Suite 108
O Fallon, MO 63368

8 a.m.-8:30 a.m. Walk-in Sick Hours. 8:30 a.m.- 5:00 p.m. appointments Monday-Friday. Extended hours on Tuesday, Wednesday evenings
Please see below for our patient forms.

 
General Forms and Information
- MyBJC Proxy Access and Consent Form-Access your child's lab results, message your provider, etc. 
- Authorization for Release of Health Information
- After-Hours Nurse Triage Contact Information
- Designation of Another Person to Consent for Treatment

HIPAA Form and Notice of Privacy

- HIPAA
- Notice of Privacy Practices

Services and Procedures
- Ear Piercing Information: Way to Grow Pediatrics now offers ear piercing for patients at least 6 months of age!
- Ear Piercing Consent Form
- Ear Piercing After-Care Instructions

Behavioral Health Forms
- Vanderbilt Scale Parent Informant-The Vanderbilt Scale is used to help healthcare professionals diagnose Attention Deficit Hyperactivity Disorder (ADHD).  If possible, we ask both parents to complete the form.
- Vanderbilt Scale Teacher Informant-The Vanderbilt Scale is used to help healthcare professionals diagnose Attention Deficit Hyperactivity Disorder (ADHD).  In addition to parents, we ask one to two teachers to complete a form.
636.344.2213

Fax: 636.344.2214

20 Progress Point Parkway
Suite 108
O Fallon, MO 63368

8 a.m.-8:30 a.m. Walk-in Sick Hours. 8:30 a.m.- 5:00 p.m. appointments Monday-Friday. Extended hours on Tuesday, Wednesday evenings
Please see below for our patient forms.