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**

**While we are continuing to see our current Medicaid and Managed Medicaid patients, Over the Moon Pediatrics is unable to accept new Medicaid or Managed Medicaid patients at this time. We will continue to review our status and post updates if we are able to accept new Medicaid patients in the future.**

Aetna Commercial/Whole Health

Ambetter by Superior HealthPlan

Blue Cross Blue Shield Essentials/Health Select/Premier HMO

Blue Cross Blue Shield PPO/Blue Choice

Boon Chapman

Cigna

Community Health Choice CHIP

Community Health Choice Marketplace

Community Health Choice Star

Humana

Memorial Hermann Select HMO/PPO

Multiplan PPO

PHCS PPO

Superior HealthPlan

Texas Children's Health Plan

United Health Care All Other Commercial

United Health Care PPO

Wellpoint CHIP

Wellpoint Star/Star Plus

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