Forms & Policies

Before your child’s appointment with us, quickly and conveniently access patient forms from our practice. To download the forms listed below, you will need Adobe Reader.

Please bring your completed forms with you to our office at the time of your child’s visit.

Download Patient Forms

• Medical Records Request
• New Patient Forms
• Health Care Authorization for Minors
• Medical Records Release
• ADHD Initial Assessment
• ADHD Follow-Up
• FHSAA Sports Form

Influenza Vaccination Forms

• Vaccine Information
• Influenza Vaccine Consent Form

Office Policies for Current Patients

Prescription Refill

Please allow 3 days for routine prescription refills. You may call the office during working hours for questions regarding prescriptions.

Form Requests

Please allow our staff and providers 48 hours to complete all requested forms.

Cancellation/ No Show Policy

We understand that occasionally you may need to cancel your appointment. Please notify the office of the cancellation at least 24 hours prior to the scheduled appointment. Failure to do so is considered a no-show and will be subject to an additional charge.

Contact Orange Park Pediatrics for more information or to schedule an appointment at one of our locations.