Fred Co Kids Forms

The forms below are the most commonly needed and asked for forms for schools and daycare facilities. We’ve posted them here for your convenience. If you need our preliminary forms for a visit, please check our “New Patients” page. If you need a form you do not see on our website, please contact us.

When sending in forms for schools, daycares, camps, or sports, please make sure that your portion of the forms are completed before handing them in.  Also make sure that all parts of the forms are turned in together (this is important for the provider completing the forms).  We ask for 7 to 10 business days to complete all forms.   Note: we assess a $10 processing fee for all forms completed.  We will happily waive the fee if the forms are presented at the well visit.  We cannot complete any forms if your child has not had a well visit with us within the last year.

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Frederick County Pediatrics
11717 Old National Pike
New Market, MD 21774

 

Tel  (301) 882-7489

Fax   (301) 882-7520

Mon  9AM-6PM

Tue  9AM-6PM

Wed  9AM-5PM

Thu  9AM-6PM

Fri  9AM-4PM

Sat  9AM-12PM

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