Office Policies

The following policies have been established to help us serve you better.

Visit Policy

All patients under 18 years old must be accompanied by a parent or legal guardian in order to be seen or treated in our office. If you plan to have a relative or other caregiver bring your child for a visit, we require a signed form giving permission for that person to act on your behalf for medical decision making during the office visit. Please print and complete the Authorization to Treat form prior to your child’s next visit.

Authorization to Treat Form

Patient Add-on Policy

If you need to have an additional family member seen during an already scheduled visit, please call ahead of time if possible.  Otherwise, let the front team know at check-in.  All patients seen by a provider must be on our schedule, so notes from the entire visit may be recorded and so we can maintain a well-timed schedule.  Any applicable copays, coinsurance, and deductibles will be collected for each additional patient seen that day.

Late Arrival Policy

If you’re running late for an appointment due to unforeseen circumstances, we ask that you please call our office to let us know that you’re on your way, so that the providers can continue to see patients in a timely manner.  Please be aware, notifying us of late arrival does not guarantee you will be seen at your scheduled appointment time, and may result in a longer wait.  Arrival 15 minutes or more after your appointment time will result in an automatic cancellation, and a No-Show Fee may apply. A missed appointment will be rescheduled for the next available opening, which may be on a future date or with an alternate provider than with whom you normally schedule.

Cancellation/No-Show Policy

Middleton Pediatrics is dedicated to meeting the needs of our patients. In an effort to make sure we have adequate openings for all children needing appointments, twenty-four (24) hour cancellation notification is required. Failure to notify us or same-day cancellations (with the exception of acute visits) will result in a $40.00 no-show fee. Please note that insurance companies do not cover these fees, therefore you will be responsible for payment.

Walk-In Policy

Middleton Pediatrics offers Walk-In Monday-Friday from 8:15 AM-9:00 AM, in order to quickly assess your child for acute illnesses only (i.e. illnesses that have emerged overnight).  Providers may not be requested and patients are seen on a first-come, first-served basis, so we can accommodate all walk-ins in a timely manner.  More complicated illnesses, ongoing symptoms, and newborns under 2 months of age should not be seen during Walk-In, in order to allow adequate time for discussion.  After designated Walk-In time, all visits are by appointment only.  Patients who arrive after 9:00 AM for Walk-In will be asked to schedule an appointment in the next available slot that day.

After Hours Call Policy

When we are not in the office (evenings/weekends) someone is always available by phone to answer your questions. Please call the office at (407) 284-6460, and follow the prompts. Please be aware that there is a fee of $30.00 for calls to the on-call clinical team member (Dr. Middleton, Dr. Von Edwins, Christine May, Lauren Freeman, Briana McLain, Lucy Aitcheson, Joanie Gavin, Lauren Collins or Kathleen Angstrom).  If there is no answer, please leave a detailed voicemail with your child’s name, birthday, and callback number for the nurse or provider.  Our policy is to return your call within 30 minutes. We ask that if you do not hear from us by then, please try again.

Triage-Call Policy

If you have a concern about your child and would like to speak to a nurse during office phone hours (8:15 am – 4:45 pm), please call the office directly.  A detailed message regarding your questions, concerns, and the child’s symptoms will be taken over the phone, and sent directly to the clinical team.  All calls will be returned prior to leaving for the day.  Please be aware that certain symptoms and illnesses should be seen in the office in order to be properly assessed.  Therefore, you may be advised to schedule an appointment by a member of our Front Team at the time of your initial call, in order to prevent a delay in having your child seen that day.  Triage-calls that require a more in-depth discussion will also be asked to make an appointment with a provider.

Email Policy

We cannot guarantee that email communication is secure and confidential, which may be a concern given the private nature of medical information.  Therefore, if you choose to send or receive information via email, it is with this understanding on your part. We encourage patients to utilize the Patient Portal and/or MEND, which provides secure means for communication between patients and our office in a timelier manner.  However, email and the Patient Portal are NOT adequate means for URGENT questions or concerns.  Any response needed in less than 48 hours should be addressed by calling our office directly.

Records Release Policy

You may request a copy of your child’s medical records at any time.  This request must be in writing by filling out a Records Release Authorization Form.  Records cost $10.00 for a printed or CD copy.  Records can be faxed directly to other physicians free of charge.  All outstanding balances must be paid in full before records are transferred to another office.  To obtain a Records Release Authorization Form, please contact one of our Family Care Coordinators at or by calling the office directly.

Payment Plan Policy

Payment plans may be set up under circumstances in which the guarantor receives an unexpected bill for services denied by insurance.  Payment plans may only be set up for an open balance.  Any future, additional balance cannot be accrued on the payment plan and must be paid in full at the time of service.  Payment plans are not designed for high deductible insurance policies. Therefore, the responsible party is expected to pay for services applied to a deductible or coinsurance at the contracted rate within 30 days of receiving a bill.  Failure to pay these balances in full is a breach in the contract between the guarantor and insurance company.  Additionally, self-pay patients may not utilize payment plans for their balance and are required to pay at the time of services, as stated in the self-pay agreement form. To request information about a payment plan, please call our office, or email us at

Rotating Well-Visit Policy

There are several planned well-visits during the first two years of life.  Our policy is to alternate these visits between a physician and nurse practitioner to allow you to get to know our team and allow us to serve your family best.  Sick visits and last-minute scheduling may result in seeing a different provider than with whom you would normally schedule, and our alternating visits from 0-18 months allow you to establish a relationship with the entire team from the start.  Well-visits after 18 months of age may be scheduled with your provider of choice.

Vaccine Policy

Please read Middleton Pediatrics’ policy on vaccinations.

Middleton Pediatrics reserves the right to make changes to the office policies at any point in time.  Please understand that the intent of these policies is to aid us in offering a high standard of care to our patients.


Office: 407.284.6460
For all emergencies, dial 911
For Poison Control, dial 800.222.1222