REQUEST FOR RECORDS & NOTES
Please complete this form to request immunization records, school notes, health statements, and athletics physicals from the office. Forms can be sent to email@example.com for the Doctor and office staff to complete.
- If your child was seen for a Well Check in the past year, please download the General Athletics Physical Form, complete the first page, and submit it to our email.
- If your child was not seen for a Well Check in the past year or your school needs a recent physical exam, please request a "Consult" office visit.
The parent must complete the parent/student portion for all forms prior to requesting Doctor's completion. Forms may be emailed to firstname.lastname@example.org or dropped off at the office.
Please allow 1 business day for forms to be completed.