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Big Horn Pediatrics & Family Medicine - Buffalo, WY 

Patient Registration Forms

and Records Request

Please print out forms and return at the time of your appointment. Please bring your insurance card to your appointment to complete registration.

Please print out forms and return at the time of your appointment. Please bring your insurance card to your appointment to complete registration.

Please print out forms and return at the time of your appointment. Please bring your insurance card to your appointment to complete registration.

Print this form and send to your previous medical provider to obtain your records for continued care at Big Horn Pediatrics. 

If you would like immunization records, or need records transferred to an alternative provider, please allow 72 hours for records requests. Contact us at 307-687-1300, or email us at bhpfm@bighorn.pcc.com  

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