Forms for School and Camp

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Medical forms for school and camp may be emailed to our nurses (nurse@thepediatriccarecenter.com) or dropped off at the front desk.  Please note that patients must have had a well check within the previous 12 months in order for us to complete the forms.   

 

We require that parents or patients fill out all demographic information (patient's name, date of birth, etc) before sending us the forms; any forms that arrive without this information will be returned. 

 

At peak times, please allow at least one week for forms to be returned to you.   We fill out thousands of forms every year, especially in the summer months, and ask for your help in getting the forms to us well before their due date.  

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For patients 18 and up, all health forms must be returned to the patient rather than to the parent.  Please ensure that we have an up-to-date email address for these young adult patients.  

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Vaccine records can be viewed and downloaded directly from the portal.  

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Links to Commonly Used Forms

 

Maryland Lead Testing Form

Maryland Immunization Certificate

Maryland Health Certificate/Physical Examination Form

Medication Authorization Form (Montgomery County)

Emergency Action/Epipen Form (Montgomery County)

DC Universal Health Certificate and Immunization Form

DC Medication Authorization Form

DC Anaphylaxis Action Form

DC Asthma Action Plan

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