These forms are available for download in .pdf format. To download forms, simply click on your choice and after the form opens in Adobe Reader, select the Print option.
- Health Questionnaire
- Protected Health Information Designation Form
- Medication History Authorization
- Authorization to Disclose Protected Health Information - Sharecare
- Acknowledgement of Receipt Notice of Privacy Practices
- Patient Information Sheet
- Financial Policy
- Consent to Treat Minor
- Parent's Request and Physician's Information for Administration of Medication In the School
- Parent's Request and Physician's Authorization for Self-Administration of Asthma and Other Emergency Medication
- High School Athletics Participation Requirements Form
- North Carolina Health Assessment Transmittal Form
- Winston-Salem/Forsyth County Schools Kindergarten Form
- Winston-Salem/Forsyth County Schools Middle School Athletics Form
- Winston-Salem/Forsyth County Schools High School Athletic Form
Information Regarding Sports and Kindergarten Physicals
Sports and Camp Physicals
Forsyth County Schools and surrounding counties require children trying out for school sports to have a physical exam annually. Camps and day cares may also require physical exams every one or two years. Even though we may see your child for other reasons throughout the year, these visits are not considered complete physicals and cannot be used to complete your child's form. If your child desires to participate in school sports or attend camp, and if a physical is needed, please call early to schedule an appointment. If your child has had a recent physical, in the last 6 - 8 months, we can complete your form for $15.00.
School systems in this area require that all children receive a complete physical within 365 days of starting kindergarten. This consists of obtaining height, weight, blood pressure, vision screen, audiogram, labwork, and updating immunizations. Each county provides a form for the physician's office to complete which should be returned to your child's school after the physical exam. Please bring this form with you to the visit. If the physical is not performed before school begins, you will have a thirty day grace period to have an examination and complete the form. These appointment slots fill up quickly, so please call early to schedule your child's examination.
Pilots who need medical certificates, visit https://medxpress.faa.gov.