Forms

New Patients

Your review of the following forms is necessary prior to your initial visit. For your convenience, they are available to download and complete prior to your appointment.

Important Information

The following forms provide information and compliance in regard to our policies, insurance, medical records and consent.

Since 2009 our form completion fees for school, sports, and camp physical forms has been $5. After careful consideration of the new, more time-intensive VHSL forms, as well as current market rates, updated form fees were approved, May 2025.

Effective 6/1/2025: Sports/School/Camp forms are $10 for each form. FMLA forms are $25 per form. Medication forms will be $10 per patient annually, and includes medication administration forms as well as Action Plans for conditions like asthma, food allergies, seizures, etc.

Payment will be collected before the form is completed.

All parent and student portions of each form must be filled out prior to submission to PAR.

PAR is required to keep a copy of the full, completed VHSL form in your child’s medical chart. Therefore, all 6 pages need to be provided, and pages 1, 2, 4 and 5 must be completed by parent and athlete prior to our completion of pages 3 and 6.

We require 3-5 business days to complete the forms.

You may pick up completed forms at the office of your choice or provide us with a self-addressed, stamped envelope for mailing.

You will need to complete a HIPAA release form if you would like for us to mail the form anywhere other than your home address.

Please be aware that if the form includes specific lab requirements or immunizations, you need to make sure those have been met before we can complete the form. A delay in obtaining lab work will increase the time frame required to complete your forms.