Form Visits

If you have school, sports, daycare or any other type of form that you need us to complete, please bring it with you to your child's well visit. If we need to complete a form at any time other than at a scheduled well visit, please see the list below or call our office to determine if an appointment is needed, and if so, what type of appointment. There is a $10 fee for all form visits (maximum of 2 forms) and a maximum 48-hour turnaround time; our goal is to provide the highest quality medical care and it takes time, attention to detail, and knowledge to complete patient forms. Form visits are not submitted to insurance, so there would be no insurance co-pay for this type of visit.
 
We cannot complete a form if your child has not had a well visit within the past year. In this case, we will schedule a well visit appointment for you as soon as possible, and complete the form at that visit (no form fee, maximum of 2 forms).
 
School/College Forms:
These include forms required by your child’s school for the kindergarten, 6th grade, and 11th grade years, and for college entrance, to prove that your child has had a physical (well visit). If your child has had a physical with us within the last year, usually all that is required is for us to provide you with the “Private Physician’s Report” from that visit. This report contains all of the information that the school requires, including your child’s current immunization record. If you did not request this report at your child’s most recent well visit, please call our office and we will send this to you via your patient portal account or by mail. For college forms that require a doctor's signature (i.e. clearance to play a college sport), a form visit is required.
 
Daycare Forms:
These include forms required by daycare providers or preschools. Most daycare providers require children to have well visits at intervals following the AAP guidelines (see Services > Well Child Visits). If your child is current with her well visits, usually all that is required is for us to provide you with the “Child Health Assessment” report from her last visit. This report contains all of the information that the daycare provider (or preschool) requires, including your child’s current immunization record. If you did not request this report at your child’s most recent well visit, please call our office and we will send this to you via your patient portal account or by mail.
 
Sports Forms:
These include any type of school/club/community sports program for which the child is required to have a physical in order to participate. If your child has had a physical (well visit) with us within the last year, then all that will be required is a form visit ($10 fee & maximum 48-hour turnaround). If the child’s last well visit was within the last 30 days, no visit is required, but the form fee and turnaround time will still apply. Keep in mind, many school sports programs require the form to be signed no earlier than June 1 in the summer preceding the school year in which they are participating. (i.e. playing fall soccer or winter basketball in 2018-19 school year, the form cannot be signed before June 1, 2018).
 
Camp Forms:
As there are many different types of camps (summer camps, scouts, sports), it is best to call our office to determine if an appointment is needed. In most cases, if your child has had a physical (well visit) with us within the last year, a form visit ($10 fee & 48-hour maximum turnaround) will be required. If the child’s last well visit was within the last 30 days, no visit is required, but the fee and turnaround time will still apply.
 
Driver Permit Forms:
The Pennsylvania Learner’s Permit application contains a section that must be completed by the applicant’s medical provider and signed in the presence of that provider. If your child has had a physical (well visit) with us within the last year, then all that will be required is a form visit ($10 fee & 48-hour maximum turnaround).
 
Miscellaneous Forms:
These include forms for volunteer programs, school trips, and any other type of program for which a doctor’s clearance/signature is required. Please call the office.

FMLA/Disability Forms for Parents:
Please allow a 48 hour turnaround time. The fee is $25.00.
Mechanicsburg Office
• 2025 Technology Parkway, Suites 108 & 109 (717) 791-2680
Camp Hill Office • 25 West Shore Drive (717) 791-2680