Forms

Please send all forms requests/pre- completed forms to forms@randolphpediatrics.com

      SCHOOL, ATHLETIC, CAMP FORMS/ ADMINISTRATIVE FORMS/ MEDICAL LETTERS –The fee to complete school/camp/athletic forms is $15 per child.  Forms will not be processed until the fee is paid.   Processing takes up to 7 days.  If you need the forms expedited, the fee is $25 for a 24 hour turnaround. This fee is not covered by insurance. 

      WORKING PAPERS - Due to COVID, we ask that you please send a an e-mail request and scanned copy of documents to the office for the doctor to complete. There is no charge for this.

 

      COPIES OF MEDICAL RECORDS - You must make the request for a copy of your child’s file in writing.  There is a minimum charge of $30.00 per patient.  This process can take up to seven (7) days from receipt of written request.

      VACCINATION RECORDS - Due to COVID, we ask that you please send an e-mail request for vaccine records. There is no charge for this.