Request an appointment - Texas Children's Pediatric Associates

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This is a service provided to parents of current Texas Children’s Pediatric Associates patients to conveniently request regular well-child visits online. This service currently is available only to patients of FM 1960 Pediatric Center - North Cypress, FM 1960 Pediatric Center - 2920 , FM 1960 Pediatric Center - Cypresswood, and FM 1960 Pediatric Center - Lakewood and Woodlands Pediatric Associates - The Woodlands.

Texas Children’s Pediatric Associates will never sell or distribute your personal information to other organizations. Read Texas Children’s privacy policy.

If your child is not a Texas Children’s Pediatric Associates’ patient, please visit find a location to locate an office in your area of town. If your child is a patient, and he or she is ill or needs to schedule a follow-up appointment, please call your pediatrician’s office. If your child is experiencing a medical emergency, please call 911.

We will respond to your request within one business day via e-mail or phone (if preferred). Please note that business days are Monday through Friday.

Thank you for using Texas Children’s Pediatric Associates online appointment request for well-child visits.

*Indicates required fields

Patient information
Patient’s legal first name*
Patient’s legal last name*
Birth date (mm/dd/yyyy)*
Street address*
City*
State*
Zip*
Name of insurance plan*
Group or policy number*
If self pay, please type "self-pay" into the insurance fields above.


Select your location*
	FM 1960 Pediatric Center - Cypresswood 8111 Cypresswood Dr., Suite 104 Spring, Texas 77379 281-376-0707	FM 1960 Pediatric Center - North Cypress 8925 Hwy. 6 North Houston, Texas 77095 281-890-6514

	FM 1960 Pediatric Center - 2920 6334 FM 2920, Ste. 300 Spring, Texas 77379 281-370-0616	FM 1960 Pediatric Center - Lakewood 13215 Grant Road, Suite 100 Cypress, Texas 77429 281-374-7457

	Woodlands Pediatric Associates 4545 Research Forest Drive., Suite A The Woodlands, Texas 77381 281-367-5100

Name of your child’s doctor*

If your child's doctor is not available, would you like to schedule an appointment with another pediatrician at the same location?* Yes No

About you
Your first name*
Your last name*
Your e-mail address*
A phone number where we can call you during business hours* (xxx-xxx-xxxx )
Alternate phone number* (xxx-xxx-xxxx)
How would you prefer to be contacted?*
Your relationship to patient
If other, please specify

About the appointment

This appointment is for well-child visits scheduled more than two weeks in advance for current patients of Texas Children’s Pediatric Associates FM 1960 Pediatric Center - Cypresswood, FM 1960 Pediatric Center - North Cypress and Woodlands Pediatric Associates - The Woodlands. If your child needs an appointment in less than two weeks or is ill, please call your child’s pediatrician’s office to schedule an appointment. If your child is a new patient, please visit find a location to locate an office near you.

If your child is experiencing a medical emergency, please dial 911 immediately.

When do you want to schedule the appointment? (Please note: Appointments must be scheduled at least two weeks in advance and are subject to availability. Our scheduling system does not allow for appointments more than 3 months in advance.)

In two weeks

In one month

Other

Please indicate the days and times you are available.

Monday	Tuesday	Wednesday	Thursday	Friday
Morning	Morning	Morning	Morning	Morning
Afternoon	Afternoon	Afternoon	Afternoon	Afternoon

Special comments concerning your availability (Please note: We can not
reply to medical questions in e-mail. If you have a question about
your child's health, please call your pediatrician's office directly.):