Join Us!

Thank you for choosing Commonwealth Pediatrics as your child's medical home.  We are honored to have you as part of our team.  Please take a moment to complete the form below.  You will be contacted within two business days with additional information about how to transfer your child's medical records and schedule a first appointment with Dr. Lock or Dr. Espinosa.  We look forward to meeting you at our office in Stoneham!

Patient Name *
Patient Name
Patient Date of Birth *
Patient Date of Birth
Parent Name *
Parent Name
Guarantor (person who carries the insurance) *
Guarantor (person who carries the insurance)
Primary Phone *
Primary Phone
Secondary Phone
Secondary Phone
Home Address
Home Address
If you have multiple children that you would like to register, feel free to provide their names and dates of birth in this section.