Forms and Policies

FORMS

OFFICE FORMS

Authorization to Release Medical Records
Authorization for Child to Receive Care
Notice of Privacy Practices
Acknowledgement of Receipt of Notice of Privacy Practices
Transition to Adult Care Brochure
Portal: Getting Started Guide
ADHD Vanderbilt Forms

SCHOOL FORMS

CT Daycare Form (ages 0 - 5 years)
CT School Form

We are happy to complete school, camp, or daycare forms for your child when needed School forms are required upon entry into Kindergarten, 7th grade, 10th grade and any year your child is participating in school sports. We require at least 3 business days notification to complete forms.  If your child is out of date with his or her well child visit, we may require you to make an appointment for an updated exam. The request for school forms can be submitted by phone, fax, or via our portalCompleted forms will be scanned into the portal and accessible for printing at your convenience.  

POLICIES

Office Policies
Payment Policies
Well plus Sick Visit Policy
Vaccine Policy
Credit Card on File Policy