Forms

This section provides additional information including links to health sites, forms, and our own doctor's advice.

Sports & Camp Physicals

Forsyth County Schools and surrounding counties require children trying out for school sports to have a physical exam annually. Camps and day cares may also require physical exams every one or two years. Even though we may see your child for other reasons throughout the year, these visits are not considered complete physicals and cannot be used to complete your child's form. If your child desires to participate in school sports or attend camp, and if a physical is needed, please call early to schedule an appointment. If your child has had a recent physical, in the last 6 months, we can complete your form.

Kindergarten Physicals

School systems in this area require that all children receive a complete physical within 365 days of starting kindergarten. This consists of obtaining height, weight, blood pressure, vision screen, audiogram, labwork, and updating immunizations. Each county provides a form for the physician's office to complete which should be returned to your child's school after the physical exam. Please bring this form with you to the visit. If the physical is not performed before school begins, you will have a thirty day grace period to have an examination and complete the form. These appointment slots fill up quickly, so please call early to schedule your child's examination.

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New Patient Forms (For new patients or demographic changes)
Authorization to Bring Child (Authorizes an additional individual to bring your child in for care)
Transferring TO/FROM (Release Form to Sign)
HIPAA (Medical privacy)

ADHD Vanderbilt Assessment Forms

Bright Futures Well Child Check Handouts

Resources

Announcements

~ Now offering Lactation Consultation ~

Assisting mothers in their breastfeeding journey, in a comfortable office environment, with a certified lactation consultant.

Flu Vaccine Clinic

Friday, October 28th & Thursday, November 3rd

2:00pm - 5:00pm (By appointment only)

Patients can also get their COVID Vaccine during this clinic if interested (6mo. to 5 Years)

We also have the COVID BIVALENT BOOSTER shot available for patients 12 & older if they have already completed the primary series.

Face Masks for Children During COVID-19

Why do we still need to wear face masks?

It is possible to have COVID-19 but not have any symptoms. That's why wearing face masks is still so important, especially for unvaccinated children. Masks reduce the chance of spreading SARS-CoV-2, the virus that causes COVID-19.

A child or adult is considered fully vaccinated two weeks after getting the final dose of COVID-19 vaccine.

Should children wear masks?

Until a child is fully vaccinated against COVID-19, they should continue to wear a face mask and keep a safe physical distance indoors around people they don't live with or who may have the virus. Anyone unvaccinated should also wear face masks outdoors in large group settings or when physical distancing isn't possible. Face masks can be safely worn by all children 2 years of age and older, including most children with special health conditions, with rare exception. Children should not wear a mask if they are under 2 years old, however, because of suffocation risk. Also, anyone unconscious or unable to remove a face covering on their own should not wear one.

When do children need to wear masks?

Children age 2 and older who are not yet fully vaccinated, with rare exception, should wear masks when they are at school, child care or camp, and while participating in group activities such as most indoor sports and outdoors sports that have close contact. They should also wear masks any time they are unable to stay a safe distance from others, such as the grocery store. Everyone should also continue to wear them when travelingâ€¯on a plane, bus, train, or other form of public transportation, and at the airport or station. If you have a medically fragile child or an at-risk adult in your household, you may want to consider having anyone at home who is not fully vaccinated wear masks at home to help protect them.

How do I help my child get used to wearing a mask?

It is understandable if your child seems afraid of wearing a mask at first. Here are a few ideas that might help make them more comfortable:

Look in the mirror with the face mask on and talk about it.

Put a mask on a favorite stuffed animal.

Decorate them so they're more personalized and fun.

Show your child pictures of other children wearing them.

Draw one on their favorite book character.

Practice wearing the face mask at home to help your child get used to it.

For children under 3, it's best to answer their questions simply in language they understand. If they ask about why people are wearing face masks, explain that sometimes people need to wear them to stay healthy.

For children over 3, try focusing on germs. Explain that germs are special to your own body. Some germs and good and some are bad. The bad ones can make you sick. Since we can't always tell which are good or bad, the face masks help make sure you keep those germs away from your own body.

The good news is, children have gotten used to masks and are less likely to feel singled out or strange about wearing them. It has quickly become the "new normal" for all of us.

What about children with special health care needs?

Children with weakened immune systems or who have health conditions that put that at high risk for infections are encouraged to wear an N95 mask for protection.

Children with medical conditions that interfere with cognitive or lung function may have a hard time tolerating a face mask. For these children, special precautions may be needed.

How do I protect my baby who is too young for a mask?

The best way to protect your baby is to practice physical distancing, and encourage people who are around your baby to wear face masks and take other measures to reduce COVID-19 risk.

We remain responsibly committed to "treating your child as one of our own" at Winston-Salem Pediatrics. By working together, we can reduce the amount of potential exposure to coronavirus within our community while simultaneously continuing to protect our children by providing vaccinations which allow them to develop necessary immunity against serious preventable diseases.

Stay well,

The physicians and staff of Winston-Salem Pediatrics