Forms: School, Camp, or Daycare

Direcciones en Español

Pediatric Associates of Alexandria has made our school, camp, and daycare forms an entirely electronic process for our patients, and these online forms are available now. 

We use DocuSign. It is a secure, HIPAA compliant and will be emailed directly back to you after it is completed. This process through DocuSign allows for easier submission, easier completion, and reliable tracking of your forms. DocuSign will also allow you to choose from many different languages in the DocuSign settings.

Please be advised if you submit multiple forms for one child, or for multiple children, you may receive them at separate times or even on separate days. All of your forms are in the queue to be completed.

• Standard fee (7 business day turnaround): $15 per form*
• Expedited fee (1 business day turnaround ): $50 per form*
• Free when it is brought to well check appointments

* Business day does not include Saturday, Sunday, office closure due unforeseen circumstances (example: inclement weather), and holidays when the office is closed (New Years, Memorial Day, Independence Day, Labor Day, Thanksgiving, and Christmas).

** Example: If an expedited form is submitted to our office on a Friday at 5:30 p.m., it will be completed by 5:30 p.m. on Monday - as long as Monday is not a holiday or closed for other reasons previously listed.

The form fee will be collected online prior to submitting it to the office.

Directions

1. Scroll through the list of forms below. You can also preview the form to see if it is the correct one your school, camp, or daycare is asking for. PAA is not responsible if the wrong form is submitted.
2. Don't see the form you need? Scroll to the bottom to find "Is your form not in our list" to upload a copy of the form you are requesting.
3. Click on "Standard Form" or "Expedited Form" to initiate the process to send it to our office. Standard form is $15 and will be turned around in 7 business days. Expedited Form is $50 and turned around in 1 business day.
4. Complete all of the required and optional portions of the form the parent/guardian is responsible for.
5. When you are done filling out all of your parts of the form, and click "Finish" it will ask for your credit/debit card information. Your card will only be charged if the form is completed by the provider and it is emailed back to you.

Please choose which type of school, camp, or daycare form you'd like to complete.

• Virginia Forms
• Maryland Forms
• Washington D.C. Forms
• Miscellaneous Forms
• College Forms

Formas: escuela, campamento o guardería

Pediatric Associates of Alexandria ha hecho que nuestros formularios de escuelas, campamentos y guarderías sean un proceso completamente electrónico para nuestros pacientes, y estos formularios en línea están disponibles ahora. A partir del 01/08/2022, ya no aceptaremos formularios que se envíen por correo electrónico, se dejen o se envíen por fax a la oficina.

Usaremos DocuSign. Es seguro, cumple con HIPAA y se le enviará directamente por correo electrónico una vez que se haya completado. Este proceso a través de DocuSign permite un envío más fácil, una finalización más fácil y un seguimiento confiable de sus formularios. DocuSign también le permitirá elegir entre muchos idiomas diferentes en la configuración de DocuSign.

Tenga en cuenta que si envía varios formularios para un niño o para varios niños, es posible que los reciba en momentos distintos o incluso en días distintos. Todos sus formularios están en la cola para ser completados.

• Tarifa estándar (entrega de 7 días hábiles): $15 por formulario*
• Tarifa acelerada (1 día hábil de entrega): $50 por formulario*
• Gratuito cuando se trae a citas de control de salud

* El día hábil no incluye sábado, domingo, cierre de la oficina debido a circunstancias imprevistas (ejemplo: mal tiempo) y días festivos cuando la oficina está cerrada (Año Nuevo, Día de los Caídos, Día de la Independencia, Día del Trabajo, Acción de Gracias y Navidad).

** Ejemplo: si se envía un formulario acelerado a nuestra oficina un viernes a las 5:30 p.m., se completará antes de las 5:30 p.m. del lunes, siempre que el lunes no sea feriado o esté cerrado por otros motivos mencionados anteriormente.

La tarifa del formulario se cobrará en línea antes de enviarlo a la oficina.

Direcciones

1. Desplácese por la lista de formularios a continuación. También puede obtener una vista previa del formulario para ver si es el correcto que solicita su escuela, campamento o guardería. PAA no es responsable si envía el formulario incorrecto para que lo completemos.
2. ¿No ve el formulario que necesita? Desplácese hasta la parte inferior para encontrar "¿Su formulario no está en nuestra lista?" para cargar una copia del formulario que está solicitando.
3. Haga clic en "Formulario estándar" o "Formulario acelerado" para iniciar el proceso para enviarlo a nuestra oficina. El formulario estándar cuesta $15 y se entregará en 7 días hábiles. El formulario acelerado cuesta $ 50 y se entrega en 1 día hábil.
4. Complete todas las partes obligatorias y opcionales del formulario del que es responsable el padre/tutor.
5. Cuando haya terminado de completar todas las partes del formulario y haga clic en "Finalizar", se le pedirá la información de su tarjeta de crédito/débito. Su tarjeta solo se cargaré si el proveedor completa el formulario y se lo envía por correo electrónico.

Elija qué tipo de escuela, campamento o formulario de guardería le gustaría completar.

• Virginia Forms
• Maryland Forms
• Washington D.C. Forms
• Miscellaneous Forms
• College Forms

Virginia Forms

Commonwealth of Virginia School Health Form

Standard Form

Expedited Form

Preview Form

Virginia Athletic Participation Form

Standard Form

Expedited Form

Preview Form

Fairfax County Public School Epinephrine Authorization

Standard Form

Expedited Form

Preview Form

Fairfax County Public School Medication Authorization

Standard Form

Expedited Form

Preview Form

Virginia Asthma Action Plan

Standard Form

Expedited Form

Preview Form

Arlington County Medication Authorization

Standard Form

Expedited Form

Preview Form

Arlington County Allergy Action Plan

Standard Form

Expedited Form

Preview Form

Arlington County Tuberculosis Screening

Standard Form

Expedited Form

Preview Form

Prince William County Epinephrine Permission Form

Standard Form

Expedited Form

Preview Form

Prince William County Medication Form

Standard Form

Expedited Form

Preview Form

Alexandria City Public School Medication Authorization

Standard Form

Expedited Form

Preview Form

Prince William County Middle School Athletic Form

Standard Form

Expedited Form

Preview Form

Maryland Forms

Maryland School Form + Lead Test Certificate

Standard Form

Expedited Form

Preview Form

Maryland Lead Test Certificate

Standard Form

Expedited Form

Preview Form

Prince George County Epinephrine Form

Standard Form

Expedited Form

Preview Form

Prince George County Health Form

Standard Form

Expedited Form

Preview Form

Prince George County Inhaler/Nebulizer Form

Standard Form

Expedited Form

Preview Form

Prince George County Medication Form

Standard Form

Expedited Form

Preview Form

Maryland State Department of Education Medication Authorization

Standard Form

Expedited Form

Preview Form

Washington D.C. Forms

DC Universal Health Form

Standard Form

Expedited Form

Preview Form

Washington DC Medication and Medical Procedure Authorization

Standard Form

Expedited Form

Preview Form

Miscellaneous Forms

Boy Scout Physical Form

Standard Form

Expedited Form

Preview Form

Food Allergy and Anaphylaxis (FARE) Action Plan

Standard Form

Expedited Form

Preview Form

Medication Authorization Form

Standard Form

Expedited Form

Preview Form

CYS Services

Standard Form

Expedited Form

Preview Form

WIC (Infant Form)

Standard Form

Preview Form

Tuberculosis Screening Form

Standard Form

Expedited Form

Preview Form

Written Medication Consent Form

Standard Form

Expedited Form

Preview Form

College Forms

University of Virginia Health Form

Standard Form

Expedited Form

Preview Form

University of Mary Washington Immunization and Tuberculosis Screening

Standard Form

Expedited Form

Preview Form

James Madison University Immunization Form

Standard Form

Expedited Form

Preview Form

George Mason Immunization Form

Standard Form

Expedited Form

Preview Form

Virginia Commonwealth University Certificate of Immunization

Standard Form

Expedited Form

Preview Form

Virginia Tech Immunization Form

Standard Form

Expedited Form

Preview Form

Other Forms

Is your form not in our list?

Standard Form

Expedited Form