top of page

Forms

Please send all form 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 5 business days from the time payment is received.  If you need the forms expedited, the fee is $25 for a 24 hour turnaround.

This fee is not covered by insurance. 

      WORKING PAPERS

The form can be e-mail or brought to the office for completion. There is no charge for this.

      MEDICAL RECORDS

You must make the request for a copy of your child’s file in writing. Once your request is received we will contact you about the fee to complete you request. This process can take up to 30 days from receipt of written request.

VACCINATION RECORDS

Please send an e-mail request for vaccine records. There is no charge for this.

bottom of page