Call us directly: 1-618-288-9305

4804 South State Route 159 Glen Carbon, IL 62034 View Location

Quickly and conveniently obtain forms from our office. To view the forms listed below, you will need Adobe Reader. You may bring or mail your completed forms to the office at the time of your visit.

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Registration Packet
All of our forms are located within these two files. You may download, print out, and fill out the necessary forms to bring into the office.

Registration Packet  Policy Packet

Insurance Information

Young Pediatrics participates in the following insurance plans (as well as other smaller plans, please call for verification):

Aetna/ US HealthCare
Beech Street
Berkshire Health
Blue Cross/Blue Shield HMO/PPO – IL
Blue Cross/Blue Shiled HMO/PPO – MO
Cigna PPO and HMO
Great West Health Plan
Healthlink HMO/PPO
United Health Care

Insurance Tips:

  • Be sure to notify your insurance company about any newborns!
  • It is vital that you have your new baby added to your policy during the stated grace period. With most insurance companies this gives you thirty days from the date of birth to have the baby added or they will deny your claims back to the the babies date of birth.
  • We will ask you for a copy of your insurance card at your initial visit in order to verify your current insurance coverage. If your insurance coverage changes, please have your new insurance cards available at the time of the visit.
  • Find out if your insurance plan covers immunizations 100%.