South Burlington Office :

Burlington Office :
(802) 846-8100

Milton Office :

Patient Forms

We are happy to provide our office forms for convenient download on your home computer. Questions about which forms you need? Please call our office and our staff will assist you in preparing for your child's first visit. You will need Acrobat Reader to view these forms.

Completed forms may be brought to the office, faxed, or sent via email to our forms only email addresses. Please do not use these email addresses for any other correspondance besides form submission.

South Burlington office email for forms: [email protected]

Burlington office email for forms: [email protected]

Milton office email for forms: [email protected]

Please allow 3 business days for completion of all school, camp and sports forms.  Forms may be expedited to be completed in 24 hours for a fee of $10 for each school or camp form and $25 for each college form.

Timber Lane Pediatrics South Burlington
51 Timber Lane
South Burlington, VT 05403-5201
Phone: (802) 864-0521
Fax: (802) 735-9621

Monday - Friday 8:30 AM - 5:30 PM
Saturday and Sunday 8:30 AM - 12:00 PM*
*Saturday and Sunday appointments for acute illness and newborn visits only

Timber Lane Pediatrics Burlington

Office location:
1127 North Avenue, Suite 41
Burlington, VT 05408

Mailing address:
PO Box 3057
Burlington, VT 05408

Phone: (802) 846-8100
Fax: (802) 735-9337

Monday 8:30AM - 5:30 PM
Tuesday - Friday 8:30 AM - 5:00 PM
Closed Saturday and Sunday

Timber Lane Pediatrics Milton
11 Haydenberry Drive, Suite 103
Milton, VT 05468

Phone: (802) 893-1200
Fax: (802) 735-9608

Monday - Friday 8:30 AM - 5:00 PM
Closed Saturday and Sunday