Forms
General Oberlin Road Pediatrics Forms
- Authorization to Release /Request Medical Information (ie. transfer of records in or out of Oberlin Rd. Peds)
- Consent By Proxy for Pediatric Care-- This allows your named family member/friend/nanny to bring the child in.
- Consent by Proxy for an Underage Teen-- This allows your teenager (ages 16 & 17) to be seen without a parent
- Cardiac Sports Screening Form-- We ask that this is filled out IN ADDITION to the school sports forms.
School, Daycare and Camp Resources (downloadable, printable forms)
- Children's Medical Report (printable generic daycare form)
- Permission for daycare to administer medications (printable form)
- NC Health Assessment Form (Kindergarten Form)
- WCPSS (Form-1702) Medication Administration Form and Autorizacion por Medicina in WCPSS en español
- Middle School Athetic Pre-participation Physical
- High School Athletic Pre-participation Physical
- Johnston County Request for Medication Administration in School
- Johnston County High School Athletic Pre-Participation Physical form
- Harnett County Athletics Pre-Participation Form
- Harnett County Request for Medication Administration in School, HCS Student agreement for self-medication
- Boy Scout Annual Health and Medical Record