Mary Jane Pionk, M.D.

8950 Villa La Jolla Drive
Suite B204
La Jolla, CA 92037
Phone: 858-558-PEDS (7337)
Fax: 858-558-7338

Monday 9:30 am - 5:30 pm
Tuesday 9:30 am - 1:00 pm
Thursday 9:30 am - 5:30 pm
Friday 9:30 am - 2:00 pm

Make an appointment


La Jolla Developmental Pediatrics is located in the La Jolla/UCSD area just west of I-5 off of La Jolla Village Drive.

For more information please read
our Frequently Asked Questions
page or call our office at


Please click on the New Patient Form above to download, print and complete the form. Please answer all the questions, providing us with as much detail as possible. You will need to submit the form prior to your first scheduled office visit to allow Dr. Pionk time to review this information before the appointment. Completed forms may be scanned and emailed to or faxed to 858-558-7338 or mailed to our office.


If parents are divorced but share custody and medical decision making for the child, each parent must complete the new patient form prior to the first office visit.

Completing and submitting the form indicates that you have also read and agreed to our Office Policies and Procedures which are posted below.

The Assessment forms listed in the Library on this site may be recommended for the diagnosis and treatment of your child. However, you do not need to complete any of these other specific forms priors to your office visit unless instructed to do so. If you have been asked to complete a specific form, please download and complete the form(s) and either fax or scan and email the completed forms to the office, or bring them with you to your next appointment.


Office Policies


Assessment Forms

  Anxiety Scale Parent Report
  NICHQ Vanderbilt Assessment Scale - TEACHER Informant
  Parent Follow Up ADHD Form
  Pediatric Cardiac Risk Assessment Form
  Pediatric Symptom Checklist-YOUTH Report (Y-PSC)
  Pediatric Symptom Checklist (PSC)
  School Follow Up ADHD Form
  School Questionnaire
  Screen for Child Anxiety Related Disorders (SCARED) CHILD Form
  Screen for Child Anxiety Related Disorders (SCARED) PARENT Form
  Strengths and Difficulties Questionnaire - 3 to 4 Year Old
  Strengths and Difficulties Questionnaire - 4 to 10 Year Old
  Strengths and Difficulties Questionnaire - 11 to 17 Year Old
  Strengths and Difficulties Questionnaire - 11 to 17 Year Old - Self
  The Childhood Asperger Syndrome Test (CAST)
  Weekly ADHD Monitoring Form

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