Category: Patient Resources
Patient Forms
Forms can be completed online through the patient portal or you can print them from our website and bring them with you to your appointment.
Archives
Archived Articles of Interest:
10 Ways to Help Kids Fall in Love with Being Outside
Adverse Health Effects of Marijuana Use
Toddler Meals Swimming in Salt
Mom’s Whooping Cough Vaccine Before Pregnancy Cuts Babies’ Risk
Talking to Children about the Shooting
Psychology Impact of the Recent Shooting
Don’t Let Plants, Bugs, and Sun Ruin Your Summer
DHMH Clinician Letter Zika Virus
External Content Disclaimer
*Please note that pages of this site may be linked to other websites, which may have different terms of use and privacy practices than Privia Medical Group. Privia does not own, control, manage, supervise, direct, or otherwise have involvement in such other websites or the content of such websites. Privia is not responsible for the content of any linked websites. Privia is not acting as an agent for these websites, nor does Privia endorse or guarantee, in any way, their websites, content, or products. Privia makes no representation or warranty regarding the accuracy of information contained in linked websites, takes no responsibility for the use of copyrighted or otherwise protected materials on such linked websites, and has no control over the privacy practices or use of user information at such linked websites.
Newsletter
Newsletter
Information for Families (American Academy of Pediatrics–AAP)
“The Talk, ” Physician Version: Special Considerations for African American, Male Adolescents
HealthyChildren.org has a constantly updated page on the novel coronavirus that covers both the science and practical guidance for parents. Other new articles for parents include:
- Working and Learning from Home During the COVID-19 Outbreak
- Social Distancing: Why Keeping Your Distance Helps Keep Others Safe
- Tips for Coping with a New Baby During COVID-19
- Positive Parenting & COVID-19: 10 Tips to Help Keep the Calm at Home
Talking to kids about COVID-19
COVID-19 – What to do if you’re sick
Doctors Are Now Prescribing Playtime
A Parent’s Guide to Social Media
Facts For Parents About E-Cigarettes & Electronic Nicotine Delivery Systems
Booster Seats Provide Protection for Older Children
Rules for Social Media, Created by Kids
Prevention is Best Protection Against Childhood Lead Poisoning
Preventing Teen Abuse Prescription Drugs Fact Sheet
Bright Futures: Family Matters – Good Nutrition for Families
Check Your Home for Cancer-Causing Radon
The Surprising Amount of Time Kids Spend Looking at Screens
Adolescents’ Use of “Pod Mod” E-Cigarettes – Urgent Concerns
National Adolescent Drug Trends in 2018
Brain injuries, other dangers of tackle football
Trampolines can cause serious injuries; use should be discouraged
There’s Now an E-Reader Just for Kids, and it Misses What Children Love about Books
External Content Disclaimer
*Please note that pages of this site may be linked to other websites, which may have different terms of use and privacy practices than Privia Medical Group. Privia does not own, control, manage, supervise, direct, or otherwise have involvement in such other websites or the content of such websites. Privia is not responsible for the content of any linked websites. Privia is not acting as an agent for these websites, nor does Privia endorse or guarantee, in any way, their websites, content, or products. Privia makes no representation or warranty regarding the accuracy of information contained in linked websites, takes no responsibility for the use of copyrighted or otherwise protected materials on such linked websites, and has no control over the privacy practices or use of user information at such linked websites.
Resources
Useful websites and books recommended by our pediatricians. Most of our age related handout sheets have additional webpages and books and can be found under “Health Maintenance“.
Websites:
www.poison.org
www.healthychildren.org
www.youngmenshealthsite.org
www.youngwomenshealth.org
www.chop.edu – useful information on immunizations and controversies
www.cpsc.gov
www.ewg.org
www.kidshealth.org
www.cdc.gov
Learning Disabilities/ADD Resources
A.D.D Warehouse
American Psychological Association – Psychology Help Center
National Association of Attention Deficit Disorders
CHADD: Children and Adults with Attention Deficit/Hyperactivity Disorder
A website that focuses on the needs of Women and Girls
Resilience: Dr. Alvord Talks about Resilience
Bullying: Stop Bullying Now: Take A Stand
Groups for Kids in the Washington, DC Metro Area
National Institute of Mental Health
Parents Ask (Because Raising Kids Raises Questions)
Parents Perspective (a weekly radio show that has a podcast available on a variety of topics)
Sports Injuries
Books:
BOOKS FOR THE BEREAVED
How to Help Children Through a Parent’s Serious Illness, by Kathleen McCue,
The Bereaved Parent by H. Schriff
On Death and Dying by Elizabeth Kubler-Ross
Questions and Answers About Death and Dying by Elizabeth Kubler-Ross
*When Bad Things Happen To Good People by Kushner
Tracks of a Fellow Struggler by Bayly
The Growing Season by Hickman
Facing Death by Kavanaugh
Books to Help Children Cope with Separation and Loss by Bowker
Explaining Death to Children by Grollman
Talking About Death: a dialogue between parent and child by Carl Grollman
They Need to Know by Gordon
Death: What do you say to a child by Davidson
Telling a Child About Death by Jackson
Answers to a Child’s Questions About Death by Stillman
*The Grieving Child: a parents guide by Helen Fitzgerald
*How It Feels When A Parent Dies by Jill Krementz
*How To Go on Living When Someone You Love Dies by Therese Rando, PhD
Losing A Parent by Fiona Marshall
Going The Distance by George Sheehan
FOR CHILDREN
Ages 3-6
Tell Me, Papa by Centering Corp
Where’s Jess? By Centering Corp.
Fall of Freddy the Leaf by Bascalia
The 10th Good Thing About Barney by Viorst
Ages 6-12
The Magic Moth by Lee
A Taste of Blackberries by Smith
Charlottes Web by White
Ages 12 and up
Sounder by Armstrong
I Heard the Owl Call My Name by Craven
The Final Mystery by Klein
GUIDES TO CANCER
Facing Cancer, a complete guide for people with cancer, their families and caregivers by Ted Stern and Mikkael Sekeres
Giving Comfort: what you can do when someone you love is ill by Linda Milstein
When A Parent Has Cancer by Wendy Harpham
External Content Disclaimer
*Please note that pages of this site may be linked to other websites, which may have different terms of use and privacy practices than Privia Medical Group. Privia does not own, control, manage, supervise, direct, or otherwise have involvement in such other websites or the content of such websites. Privia is not responsible for the content of any linked websites. Privia is not acting as an agent for these websites, nor does Privia endorse or guarantee, in any way, their websites, content, or products. Privia makes no representation or warranty regarding the accuracy of information contained in linked websites, takes no responsibility for the use of copyrighted or otherwise protected materials on such linked websites, and has no control over the privacy practices or use of user information at such linked websites.
*Please note that pages of this site may be linked to other websites, which may have different terms of use and privacy practices than Privia Medical Group. Privia does not own, control, manage, supervise, direct, or otherwise have involvement in such other websites or the content of such websites. Privia is not responsible for the content of any linked websites. Privia is not acting as an agent for these websites, nor does Privia endorse or guarantee, in any way, their websites, content, or products. Privia makes no representation or warranty regarding the accuracy of information contained in linked websites, takes no responsibility for the use of copyrighted or otherwise protected materials on such linked websites, and has no control over the privacy practices or use of user information at such linked websites.
Vaccine Info
Vaccination Schedule:
- Your Baby’s First Vaccines
- Immunization Schedule Birth – 6 years
- Immunization Schedule 7-18 years
- Immunization Catch Up Schedule
Vaccine Information Sheets
- Chicken Pox
- Flu Mist
- Flu Shot
- DTaP
- Gardasil 9
- Hepatitis A
- Hepatitis B
- HIB
- Meningitis
- Meningitis B
- MMR
- Pneumococcal
- Polio
- Rotavirus
- TDaP
- Contraindications to Immunizations/Side Effects
- Typhoid VIS
For information on vaccinations needed for travel please visit the Centers for Disease Control Website . Please contact our office to confirm availability of CDC recommended vaccinations for your travel destination well in advance of scheduled travel. Certain travel vaccines require a minimum time period in advance of travel. We will be happy to schedule an appointment for travel vaccinations available in our office or to refer you to the appropriate specialist.
External Content Disclaimer
*Please note that pages of this site may be linked to other websites, which may have different terms of use and privacy practices than Privia Medical Group. Privia does not own, control, manage, supervise, direct, or otherwise have involvement in such other websites or the content of such websites. Privia is not responsible for the content of any linked websites. Privia is not acting as an agent for these websites, nor does Privia endorse or guarantee, in any way, their websites, content, or products. Privia makes no representation or warranty regarding the accuracy of information contained in linked websites, takes no responsibility for the use of copyrighted or otherwise protected materials on such linked websites, and has no control over the privacy practices or use of user information at such linked websites.
Forms Library
School Forms:
Montgomery County Public School Forms
Authorization to Administer Prescribed Medication Released and Indemnification Agreement
Authorization to Provide Medically Prescribed Treatment Release and Indemnification Agreement
Emergency Care for the Management of a Student with a diagnosis of Anaphylaxis Health Inventory
Infant Formula Waiver/Breast Milk Feeding Plan
Maryland Department of Health and Mental Hygiene Immunization Certificate
Physical Education Physician Contact Form
Pre-Participation Physical Evaluation for Athletics
External Content Disclaimer
*Please note that pages of this site may be linked to other websites, which may have different terms of use and privacy practices than Privia Medical Group. Privia does not own, control, manage, supervise, direct, or otherwise have involvement in such other websites or the content of such websites. Privia is not responsible for the content of any linked websites. Privia is not acting as an agent for these websites, nor does Privia endorse or guarantee, in any way, their websites, content, or products. Privia makes no representation or warranty regarding the accuracy of information contained in linked websites, takes no responsibility for the use of copyrighted or otherwise protected materials on such linked websites, and has no control over the privacy practices or use of user information at such linked websites.
Parent Guides
Evaluation Tools
- Pediatric Symptom Checklist
- M-CHAT
- Acute Concussion Evaluation
- Acute Concussion Evaluation Care Plan
- Childhood Asthma Control Test
- CRAFFT Alcohol and Drug Screening
- Depression Screen
- Lead Risk Assessment Tool
- SCARED – Parent form
- SCARED – Children form
- Parent Vanderbilt Assessment
- Teacher Vanderbilt Assessment
- Parent Vanderbilt Assessment – Follow up
- Teacher Vanderbilt Assessment – Follow up
- Edinburgh Postnatal Depression Scale
- Oral Health Risk Assessment Tool
Parent Guides
- Acetaminophen/Ibuprofen Dosing Less than 20lbs
- Acetaminophen/Ibuprofen Dosing Over 20lbs
- Allergy Cleanup Checklist
- Anaphylaxis
- Asthma Action Plan
- Asthma Action Plan en espanol_
- Asthma – A Guide For Patients and Families
- Babysitter Information Sheet
- Bedtime Sleep Resistance
- Bedwetting
- Bowel Evacuation Instructions
- Car Seat Safety
- Choking-CPR
- Concussion
- Concussion Discharge Instructions
- Coxsackie Virus
- Cradle Cap
- Disposal of Unused Medicines
- Dermatology – Skin Conditions
- Ear Piercing After Care Instructions
- Environmental Hazards
- Fever-Myths and Facts
- Flu Information For Parents
- Food Allergy Emergency Care Plan
- Gender Identity
- Gun Safety
- Homemade Baby Food Tips
- Home Safety Checklist
- Insect Repellent
- Lactation Services
- Memo From a Child to His Parents
- Miralax
- Molluscum
- Newborn Instructions
- Oral Rehydration Therapy
- Peanut Allergy – Introducing Peanuts
- Peanut Allergy – Addendum Guidelines for Prevention of Peanut Allergy
- Sleep Safety Recommendations
- Specialist List
- Starting Solid Foods
- Television, Internet and Video Games
- The ABCs of Parenting Teens
- Toilet Training Guide
- Toilet Training Tips
- Vegetarian Diets 101
External Content Disclaimer
*Please note that pages of this site may be linked to other websites, which may have different terms of use and privacy practices than Privia Medical Group. Privia does not own, control, manage, supervise, direct, or otherwise have involvement in such other websites or the content of such websites. Privia is not responsible for the content of any linked websites. Privia is not acting as an agent for these websites, nor does Privia endorse or guarantee, in any way, their websites, content, or products. Privia makes no representation or warranty regarding the accuracy of information contained in linked websites, takes no responsibility for the use of copyrighted or otherwise protected materials on such linked websites, and has no control over the privacy practices or use of user information at such linked websites.
Health Maintenance
Pre-visit Questionnaires
- 2 Month Visit
- 4 Month Visit
- 6 Month Visit
- 9 Month Visit
- 12 Month Visit
- 15 Month Visit
- 18th Month Visit
- 2 Year Visit
- 2.5 Year Visit
- 3 Year Visit
- 4 Year Visit
- 5 Year Visit
- 6 Year Visit
- 7 Year Visit
- 8 Year Visit
- 9 Year Visit
- 10 Year Visit
- Sports Pre-Participation Questionairre
Ages and Stages Questionnaire
Health Maintenance Information Sheets
- 1-2 Weeks
- 2-4 Weeks
- 2 Months
- 4 Months
- 6 Months
- 9-10 Months
- 15 Months
- 18 Months
- 1 Year
- 15 Months
- 18 Months
- 2 Years
- 2.5 Years
- 3 Years
- 4 Years
- 5 Years
- 6-9 Years
- 10-12 Years
External Content Disclaimer
*Please note that pages of this site may be linked to other websites, which may have different terms of use and privacy practices than Privia Medical Group. Privia does not own, control, manage, supervise, direct, or otherwise have involvement in such other websites or the content of such websites. Privia is not responsible for the content of any linked websites. Privia is not acting as an agent for these websites, nor does Privia endorse or guarantee, in any way, their websites, content, or products. Privia makes no representation or warranty regarding the accuracy of information contained in linked websites, takes no responsibility for the use of copyrighted or otherwise protected materials on such linked websites, and has no control over the privacy practices or use of user information at such linked websites.