Policies, Forms & Office Hours

Updated December 21, 2022

Dr. Bou Pediatrics reserves the right to make changes to the office policies at any point in time. 


Vaccination is a crucial step necessary to combat and prevent the spread of fatal diseases. We strictly follow American Academy of Pediatrics and CDC guidelines on vaccinations, which include combining certain shots at certain ages to maximize the patient’s immunity. Unfortunately, we will not be able to provide religious exemptions or accept patients that desire alternative vaccination schedules.

Unaccompanied Minors

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. Relatives or other caregivers may bring the patient for a visit, but we require signed authorization.

Unassociated Providers

Unless otherwise approved by one of our providers, we do not accept patients that desire to remain established with other practices, as we find it to be extremely detrimental to the patients’ overall healthcare.

Late Arrivals

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 that notifying us of late arrival does not guarantee you will be seen at your scheduled appointment time and may result in a longer wait. Arriving 15 minutes or more after your appointment time will result in an automatic cancellation. A missed appointment will be rescheduled for the next available opening, which may be on a future date.

Cancellations & No-Shows

In an effort to make sure we have adequate openings for all children needing appointments, twenty-four (24) hour cancellation notification is required. The patient may be discharged from our practice if they fail to cancel any appointment which results in a no-show.

Walk-Ins & Add-Ons

If we have space, patients without appointments will be offered the next available appointment. We cannot guarantee availability if you bring an additional family member to be seen during an already scheduled visit.

After Hours

When we are not in the office (evenings/weekends/holidays) someone is always available by phone to answer your urgent medical questions. Please call the office and follow the prompts. 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. Therefore, if you do not hear from us by then, please try again.


To comply with HIPAA, our office may not send information protected by HIPAA via unencrypted email. Instead, we can mail, fax, or send an encrypted email (requiring a password to view). We encourage patients to utilize the Patient Portal, which provides secure means for communication between patients and our office in a timelier manner. Additionally, neither email nor the Patient Portal are 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

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 can be faxed directly to other physicians free of charge.


Patient-Centered Medical Home FAQ for Patients
Learn more about our Patient-Centered Medical Home (PCMH)
TC 09 - PCMH FAQ for Patients Web 2022-0
Adobe Acrobat Document 134.3 KB
Notice of Privacy Practices
Check out our Notice of Privacy Practices.
DBP Notice of Privacy Practices.pdf
Adobe Acrobat Document 467.2 KB
Medical Records Release Form- Wesley Chapel
Medical Records Release Form for the Wesley Chapel location
Medical Records Release Form 2018-06-12
Adobe Acrobat Document 135.7 KB
Medical Records Release Form- Plant City
Medical Records Release Form for the Plant City location
Medical Records Release Form 2018-06-12
Adobe Acrobat Document 136.7 KB


Dr. Bou Pediatrics observes the following holidays throughout the year. If the holiday falls on a weekend, we will close on the nearest weekday.

  • January- New Year's Day & MLK Day
  • March- Strawberry Festival Parade (Plant City location only)
  • April- Good Friday
  • May- Memorial Day
  • July- Independence Day
  • September- Labor Day
  • November- Thanksgiving & Day after Thanksgiving
  • December- Christmas Eve & Christmas