Here are various forms you can fill out, for our office or for school. |
| Are you transferring your child's care to my office from another doctor? You may download this form, and send it to your previous doctor. (They may charge a fee for copying records.) | Medical Records Transfer .pdf ** Please note: Old records are helpful, but you do NOT have to transfer records in order to receive care here. Don't wait for the old records to arrive before scheduling an appointment! ** | Medical Records Transfer .htm |
| It is useful for me to have a brief list of family illnesses. You can complete this form and bring it to your first visit. Check with all your close relatives! | Family History .pdf | Family History .htm |
| The CDC has developed Vaccine Information Sheets which describe the benefits and expected side effects of each immunization. You may read them before your checkup. (Check the visit schedule to see which immunizations your infant is due for.) | Vaccine Information Sheets (CDC website) | |
| Delaware public and private schools are required to collect a doctor's form for each high school student involved in school sports. You can download the forms here. Please fill in as much information as possible (such as the child's name, address etc.) before bringing it to us for signing. | DIAA Sports Form 5 pages .pdf | DIAA Sports Forms web page |
| Asthma "action plans" are sometimes required by school nurses. They need instructions when a student with asthma starts wheezing. These forms must be signed by the doctor. | Asthma Action Plan | Asthma Action Plan |
| A skin test for Tuberculosis (PPD) is required for all new school entrants. The skin test must be checked 48-72 hours after we plant it. If the school RN is willing to check the reaction, please ask her to complete and fax this form to us. | School Nurse PPD Reading Form .pdf | School Nurse PPD Reading Form .htm |