Frederick (TJ): (301)694-0606
Ballenger: (301)668-6347
Mt. Airy: (301)829-6146
Urbana: (301)874-6107
TEXT:
(301)205-5112
FAX: (877)276-4919
Home
Locations & Hours
Providers
Forms
RESOURCES
DOSING CHARTS
BRIGHT FUTURES HANDOUTS
New Patients
FAQs
Frederick Pediatric Associates Forms:
-
HIPAA
Release Form
-
Notice of Privacy Practices
- Policy Acknowledgement Form
-
Records Request
- existing patients
Behavioral Health Screening Tools:
-
Parent Vanderbilt Assessment Form
(ADHD)
-
Teacher Vanderbilt Assessment Form
(ADHD)
-
SCARED Parent Assessment Form
(Anxiety)
-
SCARED Child Assessment Form
(Anxiety)
Ear Pierci
ng:
-
What You Need to Know
-
Consent Form
-
After Care
-
HeathyChildren.org Handout
Frederick County Public School Forms:
-
Student-Athlete Packets
- Physical Examination
- Medication Authorization
-
Asthma Medication
- Anaphylaxis / Allergy
[All other school forms can be found by clicking
here
]