Forms

School Entry

WCPSS School Entry Form
WCPSS form required for all students entering the public school system for the first time Kindergarten through 12th grade.

Preschool and Nursery Physical Form

Athletic PE Forms

Pop Warner Little Scholar's 2008 Physical Fitness & Medical History Form - This form must be dated after January 1, 2008 and then submitted to your LOCAL Pop Warner organization. Section II of this form must be completed in its entirety ONLY by a Licensed State Examiner (medical doctor, nurse practitioner, etc. - this may vary by state.)

Wake County High School Athletic Participation Form

Wake County Middle School Athletic Participation Form

Immunization

Immunization Record Form - for North Carolina College Applications

Well Child Exam & Immunization Schedule - each exam includes a growth and weight evaluation, a full developmental assessment and a complete physical examination.

Triangle Pediatrics Forms

Triangle Pediatrics Acknowledgement of Receipt of Notice of Privacy Form - An acknowledgement of receipt of Notice of Privacy. Also includes consent for your child's caretakers to seek medical care for your children and a consent for your teenagers to seek medical care.

Cancellation Policy Form - Due to an increasing incidence of the number of scheduled appointments which are not cancelled Triangle Pediatrics has had to follow other practices in the area and enact a written cancellation policy. We feel that this policy will continue to allow us to offer all of our patients same day sick appointments and more timely physical exams.

Medical Record Release Form

Consent 18 year old