Children First Pediatrics, PC MA

PLEASE READ CAREFULLY:

Children First Pediatrics has made our school, camp, and daycare forms an entirely electronic process for our patients via DocuSign. DocuSign is secure and HIPAA compliant. When the form is completed, it will be emailed directly back to you from Docusign. This process allows for easier submission, easier completion, and reliable tracking of your forms. Please be advised if you submit multiple forms for one child, or for multiple children, you may receive them at separate times or even on separate days. All of your forms are in the queue to be completed.

Standard fee (5-7 business day turnaround): $30 per form*
Expedited fee (1-2 business day turnaround ): $50 per form*
Medicaid/WELL TODAY (5-7 business day turnaround) Free when it is electronically initiated during the well appts -or within 2 days of the well appt.

* Business day does not include Saturday, Sunday, office closure due unforeseen circumstances (example: inclement weather), and holidays when the office is closed (New Years, Memorial Day, Independence Day, Labor Day, Thanksgiving, and Christmas).

Example: If an expedited form is submitted to our office on a Friday at 5:30 p.m., it will be completed by the end of CFP’s business day on Tuesday - as long as Monday is not a holiday or closed for other reasons previously listed.

The form fee will be collected online prior to submitting it to the office.

Directions

Scroll through the list of forms below. CFP has updated our list of forms, please review it entirely before selecting. CFP is not responsible if the wrong form is submitted.
Don't see the form you need? Scroll to the bottom of the forms page to find the link to upload your form for us to complete. Make sure the form is not already online here.
Click on "Standard Form", "Expedited Form" or "Medicaid/Samedaywell" to initiate the process to send it to our office. Standard form is $30 and will be turned around in 5-7 business days. Expedited Form is $50 and turned around in 1-2 business day. WELL TODAY/MEDICAID are no charge and will be done in 5-7 business days from receipt of forms.
Complete all of the required and optional portions of the form the parent/guardian is responsible for and be sure to click "FINISH". If you don't see the word FINISH or it is not highlighted, you have not completed all required information.
When you are done filling out all of your parts of the form, and click "Finish" it will ask for your credit/debit card information.
Please note: If your form is declined by a nurse or provider, you will be notified via email coming from Docusign.

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State of Maryland Forms

Maryland Department of Ed Child Care Health Inventory-occ 1215

Maryland Department of Ed Medical Evaluation for Child Care-occ 1204

Maryland Department of Ed Child Care Allergy & Anaphylaxis Form-occ 1216b

Maryland Department of Ed Child Care Medication Form-occ 1216

Maryland Anaphylaxis Form Only

Maryland Immunization Form Only

Maryland Lead Certificate Form Only

Maryland Medication Authorization Form Only

Maryland Medication Administration Form For Camps Only -MD4578-B

Maryland State School Medication Administration Form

MPSSAA -Maryland Public Secondary School Athletic Assoc Form

Maryland Department of Ed Child Care Health Inventory-occ 1215

Maryland Department of Ed Child Care Allergy & Anaphylaxis Form-occ 1216b

Maryland Department of Ed Child Care Medication Form-occ 1216

Maryland Anaphylaxis Form Only

Maryland Immunization Form Only

Maryland Lead Certificate Form Only

Maryland Medication Authorization Form Only

Maryland Medication Administration Form For Camps Only -MD4578-B

Maryland State School Medication Administration Form

Maryland Department of Ed Child Care Health Inventory-occ 1215

Maryland Department of Ed Child Care Allergy & Anaphylaxis Form-occ 1216b

Maryland Department of Ed Child Care Medication Form-occ 1216

Maryland Anaphylaxis Form Only

Maryland Immunization Form Only

Maryland Lead Certificate Form Only

Maryland Medication Authorization Form Only

Maryland Medication Administration Form For Camps Only -MD4578-B

Maryland State School Medication Administration Form

County School Forms

Frederick County

Frederick County Athletic Form

Frederick County Physical Assessment & Immunization Form

Frederick County Anaphylaxis Management Form

Frederick County Asthma Medication Form

Frederick County Medication Form

Montgomery County

Montgomery County Employee Leave Form 440-35

Montgomery County Home & Hospital Teaching Form

Montgomery County SR-6 Health Assessment, Lead, Immunization Form

Montgomery County SR-8 Participation in Athletics

Montgomery County Asthma Action Plan

Prince George's County

Prince George's County Health, Lead & Immunization Form

Prince George's County Athletic Participation Form

Prince George's County Medication Authorization Form

District of Columbia Forms

District of Columbia Family Member Leave of Absence Form

District of Columbia Anaphylaxis Action Plan Form

District of Columbia Asthma Action Plan Form

District of Columbia Health Medication & Medical Procedure Treatment Plan Form

District of Columbia Universal Health Form

Archdiocese/Catholic School Forms

Private Schools

Bullis

Bullis Allergy Action Plan Form

Bullis Health Assessment Form

Bullis Overnight Medication Authorization Form

Charles E. Smith

DeMatha

Gonzaga

Gonzaga Asthma Action Plan Form

Gonzaga Health Form & Immunizatons

Gonzaga OTC Meds Form

Georgetown Prep

Good Counsel

Good Counsel Health Form 26-27

Good Counsel Medication Authorization Form

Good Counsel Anaphylaxis Emergency Plan Form

McLean

St. Johns College High School

Bullis

Bullis Allergy Action Plan Form

Bullis Health Assessment Form

Bullis Overnight Medication Authorization Form

Charles E. Smith

DeMatha

Gonzaga

Georgetown Prep

Good Counsel

Good Counsel Health Form 26-27

Good Counsel Medication Authorization Form

Good Counsel Anaphylaxis Emergency Plan Form

McLean

St. Johns College High School

Camp Forms

Boy Scouts of America

BYM Camps

CampMinder Generic Health & Immunization Form

Camp Airy & Louise

Camp Hidden Meadows

Camp Saginaw

Camp Silver Beach

Christian Camps and Conferences

Cooperstown All Star Village Camp

Eagle's Nest Camp Form

JCC Lessans Camp & Anaphylaxis Form

JCC Maccabi Teen Medical Form

Perlman Camp Form

Ramah New England Camp

Sandy Hill Camp Form

The Zone Camp Form

University Forms

Cornell University

Duke University

Copy of Duke University

George Mason University Immunization Form

James Madison University Immunization Form

Salisbury University Form

Towson University Immunization Form

UMBC Form

University of Maryland Immunization Form

Virginia Tech University Form

Other Forms

CIEE Study Abroad Form

FMLA Family Member Health Condition Form WH 380F

Metroaccess Door to Door Paratransit Service Form

WIC FORM FOR FOOD/FORMULA

Online Forms

State of Maryland Forms

County School Forms

District of Columbia Forms

Archdiocese/Catholic School Forms

Private Schools

Camp Forms

University Forms

Other Forms

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