Frederick Pediatric Associates
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
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Frederick Pediatric Associates Forms:

            - HIPAA Release Form

            - Notice of Privacy Practices

            - Policy Acknowledgement Form

            - Transfer IN/OUT - Records Request

Behavioral Health Screening Tools:

            - Parent Vanderbilt Assessment Form (ADHD)
            - Teacher Vanderbilt Assessment Form (ADHD)


            - SCARED Parent Assessment Form (Anxiety)
            - SCARED Child Assessment Form (Anxiety)
            
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Ear Piercing:
          - What You Need to Know

            - Consent Form

            - After Care

            - HeathyChildren.org Handout

Frederick County Public School Forms:

​             - Student-Athlete Packets

             - Physical Examination

             - Medication Authorization

             - Immunization Certification Form

             - Anaphylaxis / Allergy

        [All other school forms can be found by clicking here]

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