Online Forms

 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. 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/SamedayWELL (5-7 business day turnaround) Free when it is electronically initiated during the well  appts -or within 2 business 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 Monday - 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

  1. 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.
  2. Don't see the form you need? Email a copy of your form to nurse@childrenfirstpediatrics.com.  Please make sure the form is not online here.  Forms emailed that are online will not be completed by emailing them.
  3. 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. 
  4. 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.
  5. 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. 
  6. Please note: If your form is declined by a nurse or provider, you will be notified via the patient portal.


State of Maryland Forms

Maryland Department of Ed Child Care Health Inventory-occ 1215

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

Maryland Anaphylaxis Form Only

MD Immunization Form ONLY

MD Lead Certificate Form Only

MD Medication Authorization Form Only

County School Forms

Frederick County Athletic Form

Frederick County Physical Assessment, Immun Form

Frederick County Anaphylaxis Management Form

Frederick County Asthma Medication Form

Frederick County Medication Form

Montgomery County Home & Hospital Teaching Form

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

Montgomery County SR-8 Participation in Athletics

Montgomery County Asthma Action Plan

Prince George's County Health, lead & Immun Form

Prince George's County Medication Authorization Form

District of Columbia Forms

DC Family Member Leave of Absence Form

DC Anaphylaxis Action Plan Form

DC Asthma Action Plan Form

DC Health Medication & Medical Procedure Treatment Plan Form

DC Universal Health Form

Archdiocese/Catholic School Forms

Archdiocese Health Assessment

Archdiocese Medication Form

Archdiocese Inhaled Medication Form

Archdiocese Allergy & Anaphylaxis Action Plan Form

Holy Cross Health Form

Private Schools

Bullis Allergy Action Plan Form

Bullis Health Assessment Form

Bullis Overnight Medication Authorization Form

DeMatha Athletic Form

Good Counsel Medication Authorization Form

Good Counsel Epi Pen Authorization Form

McLean Allergy Action Plan Form

McLean Asthma Action Plan Form

McLean Medication Authorizaton Form

McLean School Physical Examination Form

McLean School Sports Physical Form

Charles E. Smith Jewish Day School (CESJDS) Sports Physical Form

University Forms

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

Don't see your forms listed?
UPLOAD HERE: (forms uploaded here will be published to the portal when completed)