(School Forms, Camp Forms, Sports Forms, Day Care Forms)

Parents often need forms that are required for a child’s attendance or participation in school or play activities filled out by a pediatrician. The following is some information to help guide you through this process.

Forms may be completed at the well-child check-up at no charge.

• Please allow 10 working days for completion of your forms.
  
• When completion of the form requires that the child's paper medical record be retrieved and reviewed with needed information copied or summarized, a fee of $10 will be charged.
  
• If the form requires information about the child's physical condition (as opposed to a simple record of immunization), a Palo Alto Medical Information-Camino Region physician must have examined the child within the past two years.
  
• Because insurance companies do not cover completion of forms, the child's parent or guardian will be asked to pay for this service in advance. Faxed forms will not be accepted.
  
• Completed forms will be mailed to the parent, guardian or designee. The forms can also be picked up at the Medical Records office:
  Edward Dowd Pavilion, 2nd Floor
  701 E. El Camino Real
  Mountain View, CA 94040
  Department phone: 650-934-7981
  Map | Directions | Floor 2 Map
  
  
• Please pay the cashier or Release of Information coordinator and keep the receipt or form stamped "PAID."
  
• Forms may be mailed, with payment, to:
  Palo Alto Medical Foundation-Camino Region, ATTN: HIM Medical Records
  701 E. El Camino Real, M/S 31-306
  Mountain View, CA 94040

If you have any questions regarding medical records, form completion or release of information, please call the Medical Records office at If you have any questions regarding medical records, form completion or release of information, please call the Medical Records office at 650-934-7981.
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