Forms
Printable Office Forms
We have partnered with CHADIS to allow us to have all of those important developmental and mental health screenings completed PRIOR to your visit to minimize your time in the office and having to touch pens/paper! Completing these advanced tools PRIOR to your visit allows us to have them scored and ready to discuss with you at the visit. You can log in to your patient portal up to 2 weeks in advance of your appointment to complete all screenings. CHADIS forms are done at every well visit and some other visit types as well.
Behavioral Health Forms
Well Check Forms
Some of the below forms are developmental and/or important screening forms that we use as a standard of care during certain well visits. These forms will be billed to your insurance for payment. In the event your insurance does not cover this screening, the patient will be billed $15 per form. Please note that some insurances cover these screenings but charge a copay to the patient.
Mental Health/Therapy Forms
New Patient Forms
School and Camp Forms
Please include this cover page with your forms:
IMPORTANT NOTES – PLEASE READ.
- Please get your forms from the school/daycare/camp requesting them and either mail, email or fax them to us. Please make sure your parent portion is completed, the child’s name is at the top of each page and the fee is paid to avoid any delays.
- When emailing or faxing a form for completion, please make sure the receipt of payment is attached or we will not be able to complete the form and email to: nurse@childrenfirstpediatrics.com or fax 301-990-0471.
- Allow 5 business days for the completion of any school or camp form. There is a $20 fee to fill out your form and an additional $15 rush fee to fill it out 24-48hrs rather than the 5 day normal time frame. We are happy to complete these forms free of charge if you bring them to your annual physical!
- Please use this PAY FORM FEE link.
- Do not fill out the physician section and submit to us for a signature only. Doing so still results in a charge of the form fee as we still go over everything to be sure it is filled out correctly.
- For forms received on Friday, we will guarantee the form by Monday/Tues for the rush fee.
- WE DO NOT GUARANTEE FORMS DROPPED OFF ON FRIDAY FOR SATURDAY OR SUNDAY
- All Forms will be published to the patient portal when complete so you don’t have to make a trip to the office.
Other Forms
