Main: (678) 381-2630
Fax: (678)381-2627
Email: Admin@GraysonPediatrics.com
297 Cooper Road
Loganville GA 30052

Forms Request Policy

Due to the extremely large volume of requests for medical records copies, first copy is free and any additional copies will require a fee in accordance to the Georgia code O.C.G.A. S31-33-3.

There is no charge for the following forms if you request the following forms at the child’s preventive (well) visit: sports physical forms, hearing and vision forms, camp forms, immunization records. If you request these forms outside of your child’s preventive appointment you will be charged a form fee for each type of form in accordance to our fee schedule. Please allow two to three business days for these forms to be completed and these forms are completed on a first in/first out basis. We make every effort to complete these forms a quickly as possible. Due to the heavy volume of requests during back-to-school months, processing times may be longer. We encourage you to plan ahead to avoid any delays in getting your child’s forms.

Parents are required to complete all information on the forms that they have knowledge of (i.e. name, date of birth, allergies to medications/foods, any demographic information, health history, etc), and the parent is required to sign and date their portion of the form.  Incomplete forms will cause a delay in the completion of your child’s forms.

Parents will be required to provide self-addressed, stamped envelopes or pick up the forms at the office. Our office will notify you by phone and/or via the patient portal that your forms are ready for pick up at the office. Due to HIPPA Privacy regulations, we will no longer complete forms via fax.