Forms
Everything You Need: Forms Library
Whether you’re a new patient or completing school or medical forms, we’ve made it easy to access the forms you need in one convenient place. Be sure to review the instructions and helpful tips below to ensure smooth form completion.
Registration & Records Forms
🔹New Patient Registration Packet
🔹Notice of Privacy Practices
🔹Trusted Doctors Information Sharing
(Patient gives consent for parents to access protected health information)
School & Daycare Forms
ADD/ADHD Forms
Miscellaneous Forms
Instructions &
Helpful Tips
Questions? Please call us at
(301) 662-0133 or email us at forms@thepedcenter.com
Before Submitting Your Forms:
- Print all pages: Be sure to print all pages from the form you need.
- Complete the parent portion: Fill out all required sections and sign the form before submission.
- Submit your form: Email: forms@thepedcenter.com, Fax: (301) 695-8604, Mail, or In-person drop off.
Form Fee
To help cover processing time, a $10 fee applies if forms are completed outside of an appointment.
Processing Time
Forms are typically completed within 3-5 business days (excluding weekends and holidays).
Well Visit Requirements
Most forms require a well visit within the last year. Please review the form to ensure you meet the specific requirements of the requesting organization.
Looking for something else?
Need a vaccine record?
Email us at records@thepedcenter.com with the patient's name and date of birth. With your permission, we will email the record to you. Alternatively, you can register for Maryland MyIR, a free service that allows you to access and print official vaccination records directly from ImmuNet, Maryland's immunization system.
Need a prescription refill?
You can call our office at (301) 662-0133 and follow the prompts for the prescription refill line, or complete our Prescription Refill Request Form and email to refills@thepedcenter.com.
Please allow 3 business days (Monday-Friday) to process.
