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Phone
Suite #100 Rockville, MD 20850
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. We have not forgotten about any forms submitted. All of your forms are in the queue to be completed and will be returned within 5-7 business days. Please do not email inquiring about your “other forms” if you have already received one of them unless it is beyond 7 business days from the date of submission.
Follow these easy steps HERE
Immunization records are attached to all health forms and have a Potomac Pediatrics stamp. Due to the nature of this process, we do not “sign” the form but the stamp constitutes an official record.
If you only need an immunization record, please request it HERE.
After you’ve submitted your forms (via verifying your digital signature) they will immediately drop into our queue for completion. When your forms are completed, you will immediately receive a finalized copy in your email from PROOFPOINT.
In order for Potomac Pediatrics to complete health forms for your child, they are REQUIRED to have a physical within the past 12 months. You can verify if your child is up to date by logging into your patient portal and checking their appointment history or by contacting our office. Any request for health forms received for a patient that does not have an up to date well exam will be declined. Forms submitted prior to a scheduled well exam will be held until the appointment occurs at which time we will complete the requested forms. Please note that completion will not occur at the time of the appointment.
Potomac Pediatrics will always be fully focused on helping your child and you to overcome any healthcare hurdle, with innovative, comprehensive and compassionate care.
