Refer A Friend

One of the highest compliments that Pediatric Associates can receive is your trust in our physicians! If you have a friend, relative or co-worker who would like to become a patient at one of our offices, please fill out the information below. To thank you for believing in us, we will enter you in a raffle to win a $50 Publix Gift Card (upon completion of your friends first office visit at one of our convenient locations)!

Refer the most patients to our practice this year and you will win a $400 Toys R’ Us gift card!

  • Step One: Fill out the information below
  • Step Two: An email will be sent to your friend at the address you have provided
  • Step Three: We will contact your friend if they respond saying that they would like more information about our offices
  • Step Four: Your friend comes to the office for an appointment, you are automatically entered in the raffle

Referral Information


Please limit your personal note to 600 characters or less

Your Information

* Denotes required fields.

*Drawing will be held each quarter and winner will be notified by email. Valid for new patients only, or patients who have not been to a Pediatric Associates location for at least two years prior. Employees of Pediatric Associates and other healthcare providers are not eligible to enter.

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