Mason Pediatrics Patient Forms


Thank you for choosing Mason Pediatrics. For your convenience, we have provided links to our patient forms.

If you are a new patient please click the All New Patient Forms link, print it, fill it out and bring it to your first appointment along with your insurance card and a photo ID.




Request to Update Primary Care Provider

If you have selected a new insurance plan or will be new patient, please make sure you have selected one of the physicians in our group as your child’s primary care physician. You may call the phone number on the back of your insurance card to request the change. Please obtain a call reference number to provide to our staff during your next visit as confirmation of this change. You may also use one of the forms below, for applicable Medicaid plans. If using one of the forms, please print it and bring it to your child’s next appointment.

We look forward to caring for you and your family.

  • Mason Pediatrics

    665 Duluth Highway, Ste. 920
    Lawrenceville, GA 30046

    Hours of Operation

    Monday - Friday: 8 a.m. - 4 p.m.

    Call for same-day availability.

  • Mason Pediatrics
    665 Duluth Highway Ste. 920
    Lawrenceville, GA 30046

    Office: 678-730-1620

    Fax: 678-730-0858

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