Patient Forms
Download Documents
To help speed up the check-in process, especially at your first appointment, you can download, print out, and complete the patient forms below before your visit. Have questions? Call (205) 946-0725.
To help speed up the check-in process, especially at your first appointment, you can download, print out, and complete the patient forms below before your visit. Have questions? Call (205) 946-0725.
Please call us to schedule an appointment.
We are a family of community-based clinics in Jefferson County, Alabama, committed to providing affordable and high-quality care to its patients, regardless of insurance status or income.
Monday through Friday,
7:45 a.m. to 5 p.m.
Woodlawn, Chalkville
and Roebuck
Click Here to Make
Your First Appointment
Christ Health Pediatrics is recognized by the National Committee for Quality Assurance (NCQA) as a Patient Centered Medical Home (PCMH). PCMH is a model of healthcare that strengthens the relationship between providers and patients through long-term care from a care team comprised of multiple healthcare providers and led by a physician. PCMH services include same-day and evening appointments, preventive care, school physicals, an online patient portal, and self-care management.
For new patients, please come 20 minutes early to complete your check-in. We provide a 10-minute grace period for patients arriving late. After the allotted grace period, Christ Health Pediatrics reserves the right to give your appointment to another patient on the standby list.
If you do not have insurance or will need assistance paying for your care, you will also need to bring:
In order to apply for our Medicaid, All Kids First or Sliding Fee Discount Program, you will need to bring proof of income for yourself, your spouse, and any children you could claim on your federal tax return (including any disabled children you support). Proof of income documents include: prior-year W-2 forms, a pay stub from the past four weeks, most recent bank statement, employer letter stating the amount of gross pay, unemployment benefits statement, social security and food stamp benefits statements, Federal tax return, and a food stamp letter that contains income information. For pediatric patients, a Household Application for Free and Reduced Price School Meals form is also acceptable if certified by the school in which the child attends.
When you come to Christ Health Pediatrics for the first time, please bring the following:
Co-pays are due at the time of service. Please schedule a Financial Appointment to make special payment arrangements. We accept all major insurances except Viva UAB plans. We do accept other Viva plans. If you have Viva insurance, please confirm with your insurance company and our scheduling team that your plan is accepted at Christ Health.
(On the back-side of the YMCA)
628 Red Lane Road
Birmingham, AL 35215
Phone: (205) 946-0725
Schedule Appointment
(Medical and Dental Care)
5720 1st Avenue South
Birmingham, AL 35212
Phone: (205) 380-9455
2152 Old Springville Rd
Birmingham, AL 35215
Phone: (205) 838-6000
(Mental Health and Pharmacy)
5804 1st Avenue South
Birmingham, AL 35212
Phone: (205) 972-0264