Important resources for our patients!

REGISTRATION PACKET

If you are new to the practice, please click on the New Patient Registration Packet to download your forms and fill out ahead of your visit.  Individual forms are also available for download.

• New Patient Registration Packet

INDIVIDUAL FORMS

• Contact Information Form
• Use this form to update contact information for the patient(s) and parents/guardians
• Insurance Information and Credit Card on File Form
• Use this form to update your insurance information and/or your credit card/HSA card on file
• Authorization for Release of Medical Records Form
• Use this form to transfer your child's medical records to/from Over the Moon Pediatrics
• Consent to Treat Minor Form
• Use this form if someone other than a listed parent or guardian will be bringing your child in for an office visit
• Media Release Form
• Use this form to give us permission to use your child’s photo and/or information for our publications
• ImmTrac Registration
• This form allows us to register a record of your child’s vaccinations with the state of Texas

OFFICE POLICIES

You can also find our office policies on this page. 

• Financial Policy
• Vaccination Policy
• Notice of Privacy Practices

INSURANCES ACCEPTED

**please call your insurance to verify that Dr. Michelle Suhendra is a covered provider and in network PRIOR to your visit**

Aetna Commercial/Whole Health

Ambetter by Superior HealthPlan

Amerigroup CHIP

Amerigroup Star

Amerigroup Star Plus

Blue Cross Blue Shield PPO (we do not take HMO at this time)

Boon Chapman

Cigna

Community Health Choice CHIP

Community Health Choice Marketplace

Community Health Choice Star

Memorial Hermann Care/Catastrophic

Memorial Hermann Select HMO/PPO

Molina Star

Molina Star Plus

Molina Star MMP

Molina Star Plus MMP

Multiplan PPO

PHCS PPO

Superior HealthPlan

Texas Children's Health Plan

United Health Care All Other Commercial

United Health Care PPO

TELEMEDICINE

We use Spruce Health as our HIPAA-compliant platform.  If you are interested in scheduling a telemedicine visit, please call our office.  We will send you an invitation link, which will look like https://spruce.care/xxxx.  Click on the link and download the app if you are using a mobile device.  Set up your account (input your data, not your child’s), and you’re all set to go!

For more specific information or troubleshooting, see below:

Using the Spruce app as a patient

Troubleshooting

Granting Smartphone Permissions

MISCELLANEOUS FORMS

Below are some forms we commonly use in our pediatric practice.

• Ear Piercing After Care Instructions
• Texas UIL Pre-Participation Physical Form
• Vanderbilt ADHD Questionnaire - Parent Form
• Vanderbilt ADHD Questionnaire - Teacher Form

WEBSITES WITH REPUTABLE PEDIATRIC INFORMATION

• The AAP Parenting Website
• The Pediatric Advisor