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School, Sport & Camp Forms Policy

In an effort to ensure that our families have ready access to the information they need for their children’s activities and to reduce delays and disruptions to patient care due to paperwork requests, we are revised our forms policy.

You will be provided with a completed State of Connecticut school form and immunization record for your child at their next well exam.  These may be used to satisfy requests for forms from schools, camps, or sports activities anytime within the next 12 months.

We encourage you to make and hold onto multiple copies.  When you receive a request from a school, camp or athletic organization, you should attach these copies to their request for medical information.  All of the information that is needed to satisfy their requirements is included within these documents.  Providing them to your school or camp should eliminate the need for you to forward a specific form to us and then wait for our office to complete your form(s).

We are providing you with this copy free of charge at the time of your child’s well exam.

If your camp or school will not accept the information in this format and you still need to have their form completed, there will be a $5.00 charge for each form.  Please understand that each separate form that we need to complete takes time both on the part of the staff to fill out as well as by our Providers to review, amend, and sign.  To that end, we are hopeful that this minimal charge of $5.00 per form will not be an undue burden to you while allowing us to continue providing quality care we deliver with minimal disruption to our staff.  All additional form requests will still require a week for completion.

Any last minute requests for additional forms will require two weekdays and will incur a fee of $25.00.

College forms require a week for completion and will be completed free of charge.

We hope this new policy will provide you with more timely access to the medical information that you need for your child’s activities.


Your Healthcare Team at Pediatric Healthcare Associates