Bright Oaks Pediatric Center is an award winning pediatric practice in Bel Air, Maryland, providing expert, friendly care for children birth through 18 years.

Forms and Documents

Various required forms are available on this page. Our office staff and/or providers may direct you to this page to print out and complete forms prior to your visit.

All the forms are in PDF format and require Adobe's Acrobat Reader which is free. If you do not have Acrobat Reader you can download it here.

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General Forms

New Patient Form Set
BOP_Form_NewPatientSet.pdf
This PDF contains a compilation of all the forms you need for your new patient visit. Please print the entire document and complete each form using the checklist on the first page. You may also download inidividual documents below.

Office Financial Policies
BOP_Form_FinancialPolicy_031710.pdf

Patient Registration
BOP_Form_PatientRegistration_031710.pdf

New Patient History
BOP_Form_NewPatientHistory_031710.pdf

Vaccine Screening Questionnaire
2014MarylandRecommendedImmunizationSchedule.pdf

HIPAA Forms
BOP_Form_HIPAAPrivacyPolicy_031710.pdf
BOP_Form_HIPAAAcknowledgeForm_031710.pdf

Release of Medical Records
BOP_Form_ReleaseOfMedicalRecords_030403.pdf

Release for Assignment of Benefits
BOP_Form_InfoReleaseAssgnBenefits_062510.pdf

Consent for Treatment of a Minor
BOP_Form_MinorConsentToTreat_040510.pdf

Vanderbilt Assessments
BOP_Form_VanAssessScaleParent_031710.pdf

BOP_Form_VanAssessScaleTeacher_031710.pdf

BOP_Form_VanAssessFollowUpParent_031710.pdf

BOP_Form_VanAssessFollowUpTeacher_031710.pdf

Handouts

Antibiotic Usage
BOP_Handout_AntibiotUse_031710.pdf

Fever Guide and Medicine Dosages
BOP_Handout_FeverAndDosages_031710.pdf

Immunization and Physical Exam Schedules from the CDC
Children 0-6 Years Old: parent-ver-sch-0-6yrs.pdf 
Children 7-18 Years Old: parent-version-schedule-7-18yrs.pdf