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Home: Baptist Health
Virginia Black, MD

Virginia Black, MD


Primary Office

Office 1: Mandarin Pediatrics

14810 Old St. Augustine Road , Suite 106
, Jacksonville, FL 32258


  • Monday 8:30 AM - 5:00 PM
  • Tuesday 8:30 AM - 5:00 PM
  • Wednesday 8:30 AM - 5:00 PM
  • Thursday 8:30 AM - 5:00 PM
  • Friday 8:30 AM - 5:00 PM

Patient Forms

Welcome to Mandarin Pediatrics. To help expedite your first visit, we provide our health forms online so that you can print and complete them at your convenience. If you have any questions, please don’t hesitate to contact our office staff.

Mandarin Pediatrics Forms

  • BPC Authorization for Use of Answering Machines

    Authorizes Baptist Primary Care to leave appointment, referral and test results information on your answering machine.

  • BPC Health Care Status Authorization

    Authorizes Baptist Primary Care to release information concerning the status of your health care, including laboratory and radiology results and to discuss your treatment plan with an individual that you name.

  • BPC Patient Registration and Authorization

    Captures patient demographic information, insurance information and authorizes Baptist Primary Care to prepare and submit your medical bill directly to your insurance company.

  • Medical History

    Provides your primary care physician with important information about your medical and family history to better diagnose, treat or prevent conditions.

  • Medical Records Request or Release

    Initiates your request to have your medical records sent to another medical provider and/or to request your medical records from another provider be sent to your primary care doctor.

  • Parental Authorization

    Authorizes Baptist Primary Care to deliver medical services and treatment to your children.