Appointments: 

      717-652-7616

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​          FORMS

  • Daycare and School Forms:  The child must have had a Well Child Exam within the past year.  Forms can be re-printed at no cost.  If no form was created at the last visit and parent requests that one be created, there will be a $10 fee.   Forms for school will be automatically created ONLY for years when the State requires forms, such as for 6th and 11th grade.


  • Drivers Forms: If you are in need of a Drivers Form, this may be completed at your child's annual exam, as long as they are at least 15 1/2 year of age.  We do have these forms available, or you may download one from the PennDot site HERE.  There may be other criteria for having a Driver's Form completed. Please call the office for more information.​  


  • PIAA Forms Requirements: If your child requires completion of a PIAA form, please remember to complete the Health History portion prior to bringing the form to us.  Also, be sure that you hand us every page of the form.  PIAA physicals are not valid unless the child is examined AFTER  

           June 1st of the current year.  If the well check was before June 1st, a sports physical will be required before completion of the form at an out-of-pocket                cost.  If you need more information on PIAA Forms and Requirements, please check HERE.


  • Camp Forms and simple Sports Forms:  Must have an up-to-date physical.  Stay up-to-date with your child's yearly physical by calling today. 

           

  • ​ Fee:  There is a $10 fee for any form not presented at the time of a visit. 

Will your child need to be given immunizations?
Most children will receive multiple vaccines at visits during the first year and a half.  Each year, vaccines may be required, however, children who remain on the recommended vaccine schedule without falling behind, typically will not require vaccines at the 2 or 2 1/2, and the 6 through 9 year well checks, other than a possible flu vaccine.  Please note that this is just a guideline since recommendations change.  

Click HERE for more information on which vaccines your child may require.

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Your Child's Health Matters