At Piedmont Pediatrics, patient privacy is important. We cannot send any Personal Health Information via email or insecure fax. Documents containing secured information must be picked up in person at our office. Please provide a stamped, self-addressed envelope if you would like documents mailed to you.
Once you have completed the Registration form, we would like a copy of your medical history. If you already have a copy of your medical records you can deliver them to us directly. Otherwise, you can download and complete our Records Request form and we will obtain a copy from your previous provider. If at all possible it is best to complete this form at least two weeks prior to your first appointment.
It’s also a good idea to verify that we participate with your insurance policy. You can find those details on our Insurance Information page. Your preparations help ensure that you are seen quickly and have all of your needs met.
Our Privacy Policy (pdf)
The Virginia High School League (VHSL) requires the completion of their physical form prior to athletic participation. You must have a physical exam after May 1 of the upcoming school year to meet the criteria. It is best to book these appointments as early as possible to ensure that your child will be allowed to participate. You will need to give your nurse a copy of the Athletic Participation/Parental Consent/Physical Examination Form with your portion (first page) completed when you come for your appointment. Please make sure you have completed the first page prior to the visit. You will find a link to the VHSL form on our Camp and Sport Forms page.
There are many other programs that require medical paperwork. In the event that you need us to complete other documents, please submit the forms to our office with enough time for us to fill them out before the deadlines. Most forms can be completed within 48 hours.