For your convenience, please fill out your annual physical forms below a few days before your appointment. All the forms needed are listed under the corresponding age.
For New Patients: Please complete the New Patient Forms below to begin the new patient registration process.
Your forms will be submitted online and are 100% secure.
Thank you!
New Patient Office Visit
New Patient Office Visit
1st Newborn Visit
2 Week Appointment
2 Month Appointment
4 Month Appointment
6 Month Appointment
12 Month Appointment
18 Month Appointment
24 Month Appointment
30 Month Appointment
3 Year-5 Year Appointment
6 Year- 11 Year Appointment
12 Year & Up Appointment
Flu Clinic Consent Forms
Flu Vaccine Consent Form
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
- For ANY form to be signed by your physician a recent annual physical MUST be on file.
- The forms process typically takes 3-5 business days to complete.
- A $20 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
School Medication Form 1702
Kindergarten Forms
Kindergarten Health Assessment Form
What you need to know for Kindergarten
Wake County Enrollment Forms
Elementary School Health Assessment Form
To make an appointment, please contact us at (919) 460-0993.
