Forms & Screenings

forms header

Prior to each scheduled appointment, you will receive a link via text or email prior to your visit that will allow you to update your information and complete required forms securely online prior to arriving to our office.

Please complete the mobile check-in prior to your visit.*

For well visits and consults scheduled ahead of time, you can check-in up to 5 days before your visit at your convenience.
For sick visits scheduled same-day, you will receive a check-in text & email from us shortly after your appointment is scheduled.

*Please note, with this new platform, all patients must fill in all required information sections, even if you've been a patient with us for years.

Your first time completing the mobile check-in process will be a bit lengthier to get all of your information updated in our system. After that, your mobile check-in will be much faster before each visit!

And, with your information more up-to-date, Annapolis Pediatrics will no longer require families to fill out annual patient information packets!!

Patient Registration

You will receive a link via text or email prior to each visit that will allow you to update your information and complete required forms securely online prior to arriving to our office.

Please note: Your first time completing the mobile check-in process will be a bit lengthier to get all of your information updated in our system. After that, your mobile check-in will be much faster before each visit!

Authorization for someone other than parent to bring patient to visit Patient Proxy Form

Authorization for parent access for patients over 18 years old Info Access Consent

Patient Pre-Visit Screening Forms

Screenings should be sent directly to you via text, prior to your visit, via our new check-in process with Phreesia!

Some behavioral health screenings may still be accessed from the website for completion, see below:

ADHD/ADD Consult or Medcheck – Vanderbilt Teacher Form

School & Daycare Forms

You can bring your forms with you to your scheduled visit to be completed or submit them ahead of time using our “Request for Forms Completion” online link below.

To request a form to be completed, click HERE.

Please check with your school and daycare directly to access the required forms needed and deadlines for submission.

When submitting forms, always remember:

Please pre-fill out the parents portion of each form BEFORE submitting for completion. Without the parent portion pre-completed, we will need to send the form back and the process will take longer.
Please submit the actual form document. Screenshots and pictures of forms are not acceptable options.

There is a form fee for completion of school and camp forms. Please allow ten business days from the time of request to complete all forms. Forms needed within 72 business hours may be ordered for a stat fee. There is a medical record copy fee per child per chart. Please allow 5 business days for the completion of medical records. Fees must be paid prior to release.

Online Requests

Appointment Request

• This request form is for future appointments only. Same day appointments must be made by calling 410-263-6363, Option 1.

• If requesting an appointment for a new patient, please call our appointment line directly at 410-263-6363, Option 1.

• Please note that Online Appointment requests may take up to 5 business days to process.

Medical Record Request

Request for Forms Completion

• For a list of local, downloadable school and daycare forms, visit our “School & Daycare Forms” tab above.

Request for Asthma Action Plan Form Completion

Request for Food Allergy Action Plan Form Completion

NOW AVAILABLE THROUGH YOUR PATIENT PORTAL:

Refill Requests
Referral Requests
Immunization Records
General Information messaging

Need to sign up for the portal? Click HERE.

Having trouble accessing your patient portal? Email [email protected]

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You will receive a link via text or email prior to each visit that will allow you to update your information and complete required forms securely online prior to arriving to our office.

Please note: Your first time completing the mobile check-in process will be a bit lengthier to get all of your information updated in our system. After that, your mobile check-in will be much faster before each visit!

Screenings should be sent directly to you via text, prior to your visit, via our new check-in process with Phreesia!

Some behavioral health screenings may still be accessed from the website for completion, see below:

You can bring your forms with you to your scheduled visit to be completed or submit them ahead of time using our “Request for Forms Completion” online link below.

To request a form to be completed, click HERE.

Appointment Request

Locations

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You will receive a link via text or email prior to each visit that will allow you to update your information and complete required forms securely online prior to arriving to our office.

Please note: Your first time completing the mobile check-in process will be a bit lengthier to get all of your information updated in our system. After that, your mobile check-in will be much faster before each visit!

Screenings should be sent directly to you via text, prior to your visit, via our new check-in process with Phreesia!

Some behavioral health screenings may still be accessed from the website for completion, see below:

*You can bring your forms with you to your scheduled visit to be completed or submit them ahead of time using our “Request for Forms Completion” online link below.*

To request a form to be completed, click HERE.

Appointment Request

You can bring your forms with you to your scheduled visit to be completed or submit them ahead of time using our “Request for Forms Completion” online link below.