Request an Appointment

Appointment Form

Please note, This is a booking request, not a confirmed appointment. Our team will review your request and get back to you to confirm the time and date, along with additional details.
Thank you for your patience!

Please fill in the form below to book your appointment. We’re here to assist you every step of the way.

Appointment Form

"*" indicates required fields

Guardian’s Name*

Guardian’s Phone Number*

Guardian’s Email*

Address*

Patient Name

Patient Date of Birth

Appointment Type*

In-Person Consultation

Secure Video Visits

Same-day Sick Visits

Message*

Agree*

I agree to Terms of Service and Privacy Policy provided by Sun Pediatrics

CAPTCHA

Name

This field is for validation purposes and should be left unchanged.

Cancellation And Rescheduling

If you are unable to keep an appointment, please call us as soon as possible so we may use the time for other patients who need to be seen. There will be a $50 fee for missed appointments, or appointments not cancelled within the required time. Please note that this fee will be billed directly to you and not your insurance company.

Well Child Visit

Cancellation 24 hours prior to appointment

Sick Visit

2 hours prior to appointment