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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 - Cypress Station, FM 1960 Pediatric Center - Cypresswood, and FM 1960 Pediatric Center - Lakewood.

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 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 - Cypress Station
1250 Cypress Station Center
Houston, Texas 77090
281-440-1950
  FM 1960 Pediatric Center - Lakewood
13215 Grant Road, Suite 100
Cypress, Texas 77429
281-374-7457

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*
Please enter phone number in
following format: xxx-xxx-xxxx 
Alternate phone number*
Please enter phone number in
following format: 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 and FM 1960 Pediatric Center - North Cypress. 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.):

 
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