©  2018 by Bethesda Pediatrics

11325 Seven Locks Road

Suite 238

Potomac, MD 20854

(301) 299-8930

  • White Facebook Icon

Forms (camp/school/daycare)

We understand that school, sports, and camp forms are required for enrollment or participation in many programs and we are happy to complete your child’s forms for you.  As of January 1st, 2016, there is a $20 fee per form (school, daycare, camp, work, volunteer, travel, etc.).  We strive to complete forms that are brought during your routine check up immediately and return them to you at the end of the visit.  Forms that are dropped off, faxed, emailed to forms@bethesdapediatrics.com, or sent by mail are often completed within 3 to 5 business days, but we ask that you allow up to one week for completion during high volume periods.  Fees for forms must be received before forms are returned.  Payment can be made in person, submitted online or processed by phone.

Your child must have had a physical exam within one calendar year for us to complete any forms.  We also require that you submit the entire form, with the parents’ section filled out properly before submission, since we review your portion before completing our section.  Please understand that when signing off on the form, we are verifying that we have reviewed the entire form (all parts, all sections, all pages), and therefore incomplete or partial forms (only part 2, only section C, only page 4 of 5, etc.) are unable to be submitted for completion or accepted by the front desk. When part 1 of the form is submitted to the camp electronically, we require the parent to print a copy of this and include it with the section being submitted to us for completion so that we may review the complete form.

Completed forms can be returned via email, fax, or standard mail, or can always be picked up in person during our regular office hours.  Please provide a self-addressed envelope with appropriate postage if you would like the completed forms to be mailed or a phone number we may call when they are ready to be picked up during routine office hours.  Due to logistical issues, we do not keep copies of any completed forms.

Please note that sports clearance forms do not require any additional examination outside of your child’s annual physical exam.  Since our check-ups are comprehensive, a separate “sports physical” exam is not necessary for participation in athletics.