(919)460-0993


97 Cornerstone Drive, Cary NC 27519 (Stone Creek Village)

Patient Forms

For your convenience, please fill out your annual physical forms below a few days before your appointment. ALL forms needed are listed under the corresponding age group. Your forms will be submitted online and are 100% secure.

For New Patients: We kindly ask that you do not fill out your forms until your registration and appointment has been made. Thank you

New Patients

Established Patients

Flu Clinic Consent Forms
Flu Vaccine Consent Form 2017-2018

REQUEST FOR RECORDS TO BE RELEASED

Can be emailed to cp-medicalrecords@rdmgpa.com or Faxed to 919-481-3952

Staying in the practice but need records?
Medical Records Release Form

Moving TO the area / Switching TO our practice?
Medical Release Form- Transferring In

Moving OUT of the area / Switching OUT of our practice?
Medical Release Form- Transferring Out

Giving permission for someone else to bring your child for their visit?  OR for your teenager (16yr+) to come alone?

Medical Authorization Consent For Treatment 

IMPORTANT FORMS INSTRUCTIONS: PLEASE READ

SCHOOL FORMS, MEDICATION FORMS, SPORTS FORMS & CAMP FORMS

  1. For ANY form to be signed by your physician a recent annual physical MUST be on file.
  2. The forms process typically takes 3-5 business days to complete.
  3. A $10 RUSH FEE can be administered. You will receive your forms by the end of NEXT business day.

Forms, and “Annual Physical” Season, always seems to be the busiest from May – September with Summer Camps, Sports Leagues, College and Kindergarten Registrations. We ask that you keep this in mind and make your annual physical appointment 2-3 months in advance.  We may not be able to accommodate a last minute appointment for a Physical Exam during this time. 

If your child has a current physical on file, drop the forms off at the office and we will call you when they are ready to be picked up. OR they can be scanned and emailed to info-cs@rdmgpa.com. Be sure to have your portions of the form filled out before sending it in.  Unless otherwise stated, we will email the forms back to you.

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Wake County Sports Participation Forms / “Ticket to Play”
High School Sports Form

Middle School Sports Form

School Medication Form 1702

School Medication Form

Kindergarten Forms

Kindergarten Health Assessment Form

What you need to know for Kindergarten 

Kindergarten Enrollment Packet

Wake County Elementary Enrollment Forms

Elementary School Health Assessment Form

School Enrollment – For Grades 1st – 5th

Wake County Middle School & High School Enrollment Forms

School Enrollment – For Grade 6th – 12th

To make an appointment, please contact us at (919) 460-0993 or fill out the schedule an appointment form.

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