Existing Patient Forms

Below are the forms that we currently use in our office. Whether you are a new patient or have been coming to our practice for years, you can save time by printing out the necessary forms at home and bringing them with you to your next appointment.

HIPPA Addendum Form
Use this form if you would like to add or remove a person from your list of people that are allowed to view your child's medical records

Request for Release of Medical Records
The first page is for those transferring FROM WPA, the second page is for those transferring TO WPA.

*ADHD Form for Parents

*ADHD Form for Teachers

*Please make sure that ADHD Evaluations are recieved by our office at least 24 hours in advance to allow for scoring of the evaluation forms. You can either drop these forms off in our office, mail them in, or fax them.

School Forms

Request for Completion of School/Camp/Daycare Form

District of Columbia Universal Health Certificate

Maryland Health Form
- Part 1
- Part 2
- Part 3

Virginia Health Form