We will gladly complete camp, school physical or any other forms anytime if your child is up to date on his/her yearly physical exam .
If you need a form signed and your child is overdue for a physical exam, we will get it scheduled ASAP so your child gets the paperwork in on time. Just call!
In order for your child's form to be accurate, we ask you fill out the Interval History Form and send it, bring it or fax it in with the form that needs to be signed.
No child should be excluded from school, sports, camp or a trip because of paperwork!!!
Office Policy
-- HIPAA Disclosure (Federal Privacy Policy)
Common Forms for Download
-
Interval History Form
Needs to filled out for any Camp-School-Sports-Daycare - Drivers Interval History Form
-
PIAA Form
Used for most High School Sports Participation -
State of PA Public and Private School Physical Form
Standard form used by most school districts and day care centers -
PA Drivers Permit Form
Appointments are neccessary for a vision test and signature. Please see the new policy on the home page.
- Travel Abroad Worksheet
Please fill out this form if your child is traveling abroad and you are looking for vaccine or medicine reccomendations
Other Forms
- New Patient Packet Part 1 Part 1
- New Patient Packet Part 2
- New Patient Packet Part 3
- New Patient Packet Part 4
- Transfer of Records .
Handouts
- Sleep Requirements for Children
- Introducing Solids to a Baby
- Calcium Requirements for Children
- "20 Ways" to Encourage Your Kids To Use Drugs
OFFICE POLICY STATEMENTS
- HIPAA Policy
- Our Vaccine Policy
In order to view or print some of these forms you will need Adobe Acrobat Reader installed. Click here to download it