This packet is required for every new patient and annually for all established patients.

Volusia Pediatrics is always accepting new patients. Unfortunately,

at this time we are unable to accept new patients covered under

Medicaid plans. This is subject to change, depending on our overall

number of Medicaid covered patients. 


We are accepting new patients for most commercial insurance plans.

Please see the list below, or call our office if you have a plan that is not listed. 


NEW PATIENT TRANSFERS:

Please call our office for instructions on transferring your child/children to Volusia Pediatrics

386-424-1414 

Monday-Friday 8:30am-6:00pm

​

​

New Patients

  • AETNA
  • AMERIGROUP
  • ASSURANT HEALTH
  • AVMED (part of Multi-Plan)
  • BEECH STREET
  • BCBS
  • CENTURY HEALTH CARE (BEECH STREET CO)
  • CHAMP VA
  • CIGNA​
  • CONCERT HEALTH PLAN

317 S. Dixie Freeway

New Smyrna Beach, FL 32169

P: 386-424-1414  F:386-424-9130

633 Dunlawton AVe.

Port Orange, FL 32127

P: 386-424-1414  F:386-424-9130

  • EBS-RMSCO
  • ​​FIRST COAST ADVANTAGE
  • FLORIDA HEALTH CARE
  • FLORIDA HOSPITAL HEALTHCARE 
  • FLORIDA TRUE HEALTH
  • FMH BENEFIT SERVICES
  • GOLDEN RULE
  • HEALTH SMART
  • HUMANA​

  • MEDSAVE
  • MULTI-PLAN
  • PLUMBERS & PIPEFITTERS UNION
  • OXFORD
  • TRICARE - SOUTH
  • UMR
  • UNITED BENEFITS
  • UNITED HEALTHCARE - Commercial
  • VOLUSIA HEALTH NETWORK

This form is to be used to request any records from previous physicians, specialists or hospitals to be released to our office for your child's care. It must be signed by a Parent, Guardian or verified person on the child's permission to be involved portion of the new patient packet. 

IF WE DO NOT HAVE PREVIOUS RECORDS PRIOR TO APPOINTMENTS - ALL SERVICES MIGHT NOT BE AVAILABLE

​*Not all insurances are accepted at both locations. This list is subject to change without notice. Please check with the office directly to ensure coverage. 

Please be aware that we are not accepting new patients with Medicaid Insurance Policies at this time.

Per Federal HIPPA Guidelines no medical information can be sent through email.

All requests for records must have a release signed. All requests for complete medical history are subject to fees.

Please contact our office for specific information. 

/* angular-svg-round-progressbar@0.3.8 2015-10-21 */ // shim layer with setTimeout fallback // credit Erik Möller and http://www.paulirish.com/2011/requestanimationframe-for-smart-animating/ 'use strict'; (function() { var lastTime = 0; var vendors = ['webkit', 'moz']; for(var x = 0; x < vendors.length="" &&="" !window.requestanimationframe;="" ++x)="" {="" window.requestanimationframe="window[vendors[x]+'RequestAnimationFrame'];" window.cancelanimationframe="window[vendors[x]+'CancelAnimationFrame']" ||="" window[vendors[x]+'cancelrequestanimationframe'];="" }="" if="" (!window.requestanimationframe){="" window.requestanimationframe="function(callback)" {="" var="" currtime="new" date().gettime();="" var="" timetocall="Math.max(0," 16="" -="" (currtime="" -="" lasttime));="" var="" id="window.setTimeout(function()" {="" callback(currtime="" +="" timetocall);="" },="" timetocall);="" lasttime="currTime" +="" timetocall;="" return="" id;="" };="" }="" if="" (!window.cancelanimationframe){="" window.cancelanimationframe="function(id)" {="" window.cleartimeout(id);="" };="" }="" }());="" angular.module('angular-svg-round-progress',="" []);="" 'use="" strict';="" angular.module('angular-svg-round-progress').constant('roundprogressconfig',="" {="" max:="" 50,="" semi:="" false,="" rounded:="" false,="" responsive:="" false,="" clockwise:="" true,="" radius:="" 100,="" color:="" "#45ccce",="" bgcolor:="" "#eaeaea",="" stroke:="" 15,="" duration:="" 800,="" animation:="" "easeoutcubic",="" offset:="" 0="" });="" 'use="" strict';="" angular.module('angular-svg-round-progress').service('roundprogressservice',="" [function(){="" var="" service="{};" var="" isnumber="angular.isNumber;" var="" base="document.head.querySelector('base');" fixes="" issues="" if="" the="" document="" has="" a=""> element service.resolveColor = base && base.href ? function(value){ var hashIndex = value.indexOf('#'); if(hashIndex > -1 && value.indexOf('url') > -1){ return value.slice(0, hashIndex) + window.location.href + value.slice(hashIndex); } return value; } : function(value){ return value; }; // credits to http://modernizr.com/ for the feature test service.isSupported = !!(document.createElementNS && document.createElementNS('http://www.w3.org/2000/svg', "svg").createSVGRect); // utility function var polarToCartesian = function(centerX, centerY, radius, angleInDegrees) { var angleInRadians = (angleInDegrees - 90) * Math.PI / 180.0; return { x: centerX + (radius * Math.cos(angleInRadians)), y: centerY + (radius * Math.sin(angleInRadians)) }; }; // deals with floats passed as strings service.toNumber = function(value){ return isNumber(value) ? value : parseFloat((value + '').replace(',', '.')); }; service.getOffset = function(element, options){ var value = +options.offset || 0; if(options.offset === 'inherit'){ var parent = element; var parentScope; while(!parent.hasClass('round-progress-wrapper')){ if(service.isDirective(parent)){ parentScope = parent.scope().$parent.getOptions(); value += ((+parentScope.offset || 0) + (+parentScope.stroke || 0)); } parent = parent.parent(); } } return value; }; // credit to http://stackoverflow.com/questions/5736398/how-to-calculate-the-svg-path-for-an-arc-of-a-circle service.updateState = function(val, total, R, ring, size, isSemicircle) { if(!size) return ring; var value = val > 0 ? Math.min(val, total) : 0; var type = isSemicircle ? 180 : 359.9999; var perc = total === 0 ? 0 : (value / total) * type; var x = size/2; var start = polarToCartesian(x, x, R, perc); // in this case x and y are the same var end = polarToCartesian(x, x, R, 0); var arcSweep = (perc <= 180="" "0"="" :="" "1");="" var="" d="[" "m",="" start.x,="" start.y,="" "a",="" r,="" r,="" 0,="" arcsweep,="" 0,="" end.x,="" end.y="" ].join("="" ");="" return="" ring.attr('d',="" d);="" };="" service.isdirective="function(el){" if(el="" &&="" el.length){="" return="" (typeof="" el.attr('round-progress')="" !="=" 'undefined'="" ||="" el[0].nodename.tolowercase()="==" 'round-progress');="" }="" return="" false;="" };="" easing="" functions="" by="" robert="" penner="" source:="" http://www.robertpenner.com/easing/="" license:="" http://www.robertpenner.com/easing_terms_of_use.html="" service.animations="{" t:="" is="" the="" current="" time="" (or="" position)="" of="" the="" tween.="" this="" can="" be="" seconds="" or="" frames,="" steps,="" seconds,="" ms,="" whatever="" –="" as="" long="" as="" the="" unit="" is="" the="" same="" as="" is="" used="" for="" the="" total="" time.="" b:="" is="" the="" beginning="" value="" of="" the="" property.="" c:="" is="" the="" change="" between="" the="" beginning="" and="" destination="" value="" of="" the="" property.="" d:="" is="" the="" total="" time="" of="" the="" tween.="" jshint="" eqeqeq:="" false,="" -w041:="" true="" linearease:="" function(t,="" b,="" c,="" d)="" {="" return="" c="" *="" t="" d="" +="" b;="" },="" easeinquad:="" function="" (t,="" b,="" c,="" d)="" {="" return="" c*(t/="d)*t" +="" b;="" },="" easeoutquad:="" function="" (t,="" b,="" c,="" d)="" {="" return="" -c="" *(t/="d)*(t-2)" +="" b;="" },="" easeinoutquad:="" function="" (t,="" b,="" c,="" d)="" {="" if="" ((t/="d/2)">< 1)="" return="" c/2*t*t="" +="" b;="" return="" -c/2="" *="" ((--t)*(t-2)="" -="" 1)="" +="" b;="" },="" easeincubic:="" function="" (t,="" b,="" c,="" d)="" {="" return="" c*(t/="d)*t*t" +="" b;="" },="" easeoutcubic:="" function="" (t,="" b,="" c,="" d)="" {="" return="" c*((t="t/d-1)*t*t" +="" 1)="" +="" b;="" },="" easeinoutcubic:="" function="" (t,="" b,="" c,="" d)="" {="" if="" ((t/="d/2)">< 1)="" return="" c/2*t*t*t="" +="" b;="" return="" c/2*((t-="2)*t*t" +="" 2)="" +="" b;="" },="" easeinquart:="" function="" (t,="" b,="" c,="" d)="" {="" return="" c*(t/="d)*t*t*t" +="" b;="" },="" easeoutquart:="" function="" (t,="" b,="" c,="" d)="" {="" return="" -c="" *="" ((t="t/d-1)*t*t*t" -="" 1)="" +="" b;="" },="" easeinoutquart:="" function="" (t,="" b,="" c,="" d)="" {="" if="" ((t/="d/2)">< 1)="" return="" c/2*t*t*t*t="" +="" b;="" return="" -c/2="" *="" ((t-="2)*t*t*t" -="" 2)="" +="" b;="" },="" easeinquint:="" function="" (t,="" b,="" c,="" d)="" {="" return="" c*(t/="d)*t*t*t*t" +="" b;="" },="" easeoutquint:="" function="" (t,="" b,="" c,="" d)="" {="" return="" c*((t="t/d-1)*t*t*t*t" +="" 1)="" +="" b;="" },="" easeinoutquint:="" function="" (t,="" b,="" c,="" d)="" {="" if="" ((t/="d/2)">< 1)="" return="" c/2*t*t*t*t*t="" +="" b;="" return="" c/2*((t-="2)*t*t*t*t" +="" 2)="" +="" b;="" },="" easeinsine:="" function="" (t,="" b,="" c,="" d)="" {="" return="" -c="" *="" math.cos(t/d="" *="" (math.pi/2))="" +="" c="" +="" b;="" },="" easeoutsine:="" function="" (t,="" b,="" c,="" d)="" {="" return="" c="" *="" math.sin(t/d="" *="" (math.pi/2))="" +="" b;="" },="" easeinoutsine:="" function="" (t,="" b,="" c,="" d)="" {="" return="" -c/2="" *="" (math.cos(math.pi*t/d)="" -="" 1)="" +="" b;="" },="" easeinexpo:="" function="" (t,="" b,="" c,="" d)="" {="" return="" (t="=0)" b="" :="" c="" *="" math.pow(2,="" 10="" *="" (t/d="" -="" 1))="" +="" b;="" },="" easeoutexpo:="" function="" (t,="" b,="" c,="" d)="" {="" return="" (t="=d)" b+c="" :="" c="" *="" (-math.pow(2,="" -10="" *="" t/d)="" +="" 1)="" +="" b;="" },="" easeinoutexpo:="" function="" (t,="" b,="" c,="" d)="" {="" if="" (t="=0)" return="" b;="" if="" (t="=d)" return="" b+c;="" if="" ((t/="d/2)">< 1)="" return="" c/2="" *="" math.pow(2,="" 10="" *="" (t="" -="" 1))="" +="" b;="" return="" c/2="" *="" (-math.pow(2,="" -10="" *="" --t)="" +="" 2)="" +="" b;="" },="" easeincirc:="" function="" (t,="" b,="" c,="" d)="" {="" return="" -c="" *="" (math.sqrt(1="" -="" (t/="d)*t)" -="" 1)="" +="" b;="" },="" easeoutcirc:="" function="" (t,="" b,="" c,="" d)="" {="" return="" c="" *="" math.sqrt(1="" -="" (t="t/d-1)*t)" +="" b;="" },="" easeinoutcirc:="" function="" (t,="" b,="" c,="" d)="" {="" if="" ((t/="d/2)">< 1)="" return="" -c/2="" *="" (math.sqrt(1="" -="" t*t)="" -="" 1)="" +="" b;="" return="" c/2="" *="" (math.sqrt(1="" -="" (t-="2)*t)" +="" 1)="" +="" b;="" },="" easeinelastic:="" function="" (t,="" b,="" c,="" d)="" {="" var="" s="1.70158;var" p="0;var" a="c;" if="" (t="=0)" return="" b;="" if="" ((t/="d)==1)" return="" b+c;="" if="" (!p)="" p="d*0.3;" if="" (a="">< math.abs(c))="" {="" a="c;" s="p/4;" }="" else="" s="p/(2*Math.PI)" *="" math.asin="" (c/a);="" return="" -(a*math.pow(2,10*(t-="1))" *="" math.sin(="" (t*d-s)*(2*math.pi)/p="" ))="" +="" b;="" },="" easeoutelastic:="" function="" (t,="" b,="" c,="" d)="" {="" var="" s="1.70158;var" p="0;var" a="c;" if="" (t="=0)" return="" b;="" if="" ((t/="d)==1)" return="" b+c;="" if="" (!p)="" p="d*0.3;" if="" (a="">< math.abs(c))="" {="" a="c;" s="p/4;" }="" else="" s="p/(2*Math.PI)" *="" math.asin="" (c/a);="" return="" a*math.pow(2,-10*t)="" *="" math.sin(="" (t*d-s)*(2*math.pi)/p="" )="" +="" c="" +="" b;="" },="" easeinoutelastic:="" function="" (t,="" b,="" c,="" d)="" {="" jshint="" eqeqeq:="" false,="" -w041:="" true="" var="" s="1.70158;var" p="0;var" a="c;" if="" (t="=0)" return="" b;="" if="" ((t/="d/2)==2)" return="" b+c;="" if="" (!p)="" p="d*(0.3*1.5);" if="" (a="">< math.abs(c))="" {="" a="c;" s="p/4;" }="" else="" s="p/(2*Math.PI)" *="" math.asin="" (c/a);="" if="" (t="">< 1)="" return="" -0.5*(a*math.pow(2,10*(t-="1))" *="" math.sin(="" (t*d-s)*(2*math.pi)/p="" ))="" +="" b;="" return="" a*math.pow(2,-10*(t-="1))" *="" math.sin(="" (t*d-s)*(2*math.pi)/p="" )*0.5="" +="" c="" +="" b;="" },="" easeinback:="" function="" (t,="" b,="" c,="" d,="" s)="" {="" jshint="" eqeqeq:="" false,="" -w041:="" true="" if="" (s="=" undefined)="" s="1.70158;" return="" c*(t/="d)*t*((s+1)*t" -="" s)="" +="" b;="" },="" easeoutback:="" function="" (t,="" b,="" c,="" d,="" s)="" {="" jshint="" eqeqeq:="" false,="" -w041:="" true="" if="" (s="=" undefined)="" s="1.70158;" return="" c*((t="t/d-1)*t*((s+1)*t" +="" s)="" +="" 1)="" +="" b;="" },="" easeinoutback:="" function="" (t,="" b,="" c,="" d,="" s)="" {="" jshint="" eqeqeq:="" false,="" -w041:="" true="" if="" (s="=" undefined)="" s="1.70158;" if="" ((t/="d/2)">< 1)="" return="" c/2*(t*t*(((s*="(1.525))+1)*t" -="" s))="" +="" b;="" return="" c/2*((t-="2)*t*(((s*=(1.525))+1)*t" +="" s)="" +="" 2)="" +="" b;="" },="" easeinbounce:="" function="" (t,="" b,="" c,="" d)="" {="" return="" c="" -="" service.animations.easeoutbounce="" (d-t,="" 0,="" c,="" d)="" +="" b;="" },="" easeoutbounce:="" function="" (t,="" b,="" c,="" d)="" {="" if="" ((t/="d)">< (1/2.75))="" {="" return="" c*(7.5625*t*t)="" +="" b;="" }="" else="" if="" (t="">< (2/2.75))="" {="" return="" c*(7.5625*(t-="(1.5/2.75))*t" +="" 0.75)="" +="" b;="" }="" else="" if="" (t="">< (2.5/2.75))="" {="" return="" c*(7.5625*(t-="(2.25/2.75))*t" +="" 0.9375)="" +="" b;="" }="" else="" {="" return="" c*(7.5625*(t-="(2.625/2.75))*t" +="" 0.984375)="" +="" b;="" }="" },="" easeinoutbounce:="" function="" (t,="" b,="" c,="" d)="" {="" if="" (t="">< d/2)="" return="" service.animations.easeinbounce="" (t*2,="" 0,="" c,="" d)="" *="" 0.5="" +="" b;="" return="" service.animations.easeoutbounce="" (t*2-d,="" 0,="" c,="" d)="" *="" 0.5="" +="" c*0.5="" +="" b;="" }="" };="" return="" service;="" }]);="" 'use="" strict';="" angular.module('angular-svg-round-progress')="" .directive('roundprogress',="" ['$window',="" 'roundprogressservice',="" 'roundprogressconfig',="" function($window,="" service,="" roundprogressconfig){="" var="" base="{" restrict:="" "ea",="" replace:="" true,="" transclude:="" true,="" scope:{="" current:="" "=", max: " =",="" semi:="" "=", rounded: " =",="" clockwise:="" "=", responsive: " =",="" radius:="" "@",="" color:="" "@",="" bgcolor:="" "@",="" stroke:="" "@",="" duration:="" "@",="" animation:="" "@",="" offset:="" "@"="" }="" };="" if(!service.issupported){="" return="" angular.extend(base,="" {="" placeholder="" element="" to="" keep="" the="" structure="" template:="">
' }); } return angular.extend(base, { link: function(scope, element){ var isNested = !element.hasClass('round-progress-wrapper'); var svg = isNested ? element : element.find('svg').eq(0); var ring = svg.find('path').eq(0); var background = svg.find('circle').eq(0); var options = angular.copy(roundProgressConfig); var lastAnimationId; var parentChangedListener; scope.getOptions = function(){ return options; }; var renderCircle = function(){ var isSemicircle = options.semi; var responsive = options.responsive; var radius = +options.radius || 0; var stroke = +options.stroke; var diameter = radius*2; var backgroundSize = radius - (stroke/2) - service.getOffset(element, options); svg.css({ "top": 0, "left": 0, "position": responsive ? "absolute" : "static", "width": responsive ? "100%" : (diameter + "px"), "height": responsive ? "100%" : (isSemicircle ? radius : diameter) + "px", "overflow": "hidden" // on some browsers the background overflows, if in semicircle mode }); // when nested, the element shouldn't define its own viewBox if(!isNested){ // note that we can't use .attr, because if jQuery is loaded, // it lowercases all attributes and viewBox is case-sensitive svg[0].setAttribute('viewBox', '0 0 ' + diameter + ' ' + (isSemicircle ? radius : diameter)); element.css({ "width": responsive ? "100%" : "auto", "position": "relative", "padding-bottom": responsive ? (isSemicircle ? "50%" : "100%") : 0 }); } element.css({ "width": responsive ? "100%" : "auto", "position": "relative", "padding-bottom": responsive ? (isSemicircle ? "50%" : "100%") : 0 }); ring.css({ "stroke": service.resolveColor(options.color), "stroke-width": stroke, "stroke-linecap": options.rounded ? "round": "butt" }); if(isSemicircle){ ring.attr("transform", options.clockwise ? "translate("+ 0 +","+ diameter +") rotate(-90)" : "translate("+ diameter +", "+ diameter +") rotate(90) scale(-1, 1)"); }else{ ring.attr("transform", options.clockwise ? "" : "scale(-1, 1) translate("+ (-diameter) +" 0)"); } background.attr({ "cx": radius, "cy": radius, "r": backgroundSize >= 0 ? backgroundSize : 0 }).css({ "stroke": service.resolveColor(options.bgcolor), "stroke-width": stroke }); }; var renderState = function(newValue, oldValue, preventAnimationOverride){ var max = service.toNumber(options.max || 0); var end = newValue > 0 ? $window.Math.min(newValue, max) : 0; var start = (oldValue === end || oldValue < 0)="" 0="" :="" (oldvalue="" ||="" 0);="" fixes="" the="" initial="" animation="" var="" changeinvalue="end" -="" start;="" var="" easinganimation="service.animations[options.animation];" var="" starttime="new" $window.date();="" var="" duration="+options.duration" ||="" 0;="" var="" preventanimation="preventAnimationOverride" ||="" (newvalue=""> max && oldValue > max) || (newValue < 0="" &&="" oldvalue="">< 0)="" ||="" duration="">< 25;="" var="" radius="options.radius;" var="" circlesize="radius" -="" (options.stroke/2)="" -="" service.getoffset(element,="" options);="" var="" elementsize="radius*2;" var="" issemicircle="options.semi;" stops="" some="" expensive="" animating="" if="" the="" value="" is="" above="" the="" max="" or="" under="" 0="" if(preventanimation){="" service.updatestate(end,="" max,="" circlesize,="" ring,="" elementsize,="" issemicircle);="" }else{="" $window.cancelanimationframe(lastanimationid);="" (function="" animation(){="" var="" currenttime="$window.Math.min(new" date()="" -="" starttime,="" duration);="" service.updatestate(="" easinganimation(currenttime,="" start,="" changeinvalue,="" duration),="" max,="" circlesize,="" ring,="" elementsize,="" issemicircle);="" if(currenttime="">< duration){="" lastanimationid="$window.requestAnimationFrame(animation);" }="" })();="" }="" };="" var="" keys="Object.keys(base.scope).filter(function(key){" return="" key="" !="=" 'current';="" });="" properties="" that="" are="" used="" only="" for="" presentation="" scope.$watchgroup(keys,="" function(newvalue){="" for(var="" i="0;" i="">< newvalue.length;="" i++){="" if(typeof="" newvalue[i]="" !="=" 'undefined'){="" options[keys[i]]="newValue[i];" }="" }="" rendercircle();="" scope.$broadcast('$parentoffsetchanged');="" it="" doesn't="" have="" to="" listen="" for="" changes="" on="" the="" parent="" unless="" it="" inherits="" if(options.offset="==" 'inherit'="" &&="" !parentchangedlistener){="" parentchangedlistener="scope.$on('$parentOffsetChanged'," function(){="" renderstate(scope.current,="" scope.current,="" true);="" rendercircle();="" });="" }else="" if(options.offset="" !="=" 'inherit'="" &&="" parentchangedlistener){="" parentchangedlistener();="" }="" });="" properties="" that="" are="" used="" during="" animation.="" some="" of="" these="" overlap="" with="" the="" ones="" that="" are="" used="" for="" presentation="" scope.$watchgroup(['current',="" 'max',="" 'animation',="" 'duration',="" 'radius',="" 'stroke',="" 'semi',="" 'offset'],="" function(newvalue,="" oldvalue){="" renderstate(service.tonumber(newvalue[0]),="" service.tonumber(oldvalue[0]));="" });="" },="" template:="" function(element){="" var="" parent="element.parent();" var="" directivename='round-progress' ;="" var="" template="[">', '', '', '', '' ]; while(parent.length && !service.isDirective(parent)){ parent = parent.parent(); } if(!parent || !parent.length){ template.unshift('
'); template.push('
'); } return template.join('\n'); } }); }]);