Dr. Corder will have limited in-office visits as of January 1, 2024.

1-301 805-5800

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1-301 805-5800

DRCORDER.ORG

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SCHOOL FORMS AND PAPER WORK

REQUEST SCHOOL FORMS AND RECORDS

SELECT THE FORMS YOU NEED AND SUBMIT THE REQUEST. .......ALLOW 5 BUSINESS DAYS FOR COMPLETION OF FORMS

Form request

SCHOOL FORMS

If form requested is not the State of Maryland, send form to: www.pediatricmedicine06@gmail.com

School Entry Forms

35

Physical exam form

Immunization Record

Lead report (only for pre-school and kindergarten)

If form requested is not the State of Maryland, send form to:  www.pediatricmedicine06@gmail.com

Sports Physical Forms

25

Physical exam form for sports participation.

   (Must have had a physical exam within the calendar year)

If form requested is not the State of Maryland, send form to:  www.pediatricmedicine06@gmail.com

College Entry Forms

20

   Must have college forms brought to the office with child.

Form or information may be sent to:  www.pediatricmedicine06@gmail.com


INDIVIDUAL FORMS

If form requested is not the State of Maryland, send form to: www.pediatricmedicine06@gmail.com

Immunization Record

10

Current record of vaccines

If form requested is not the State of Maryland, send form to:  www.pediatricmedicine06@gmail.com

Physical Exam Form

20

Form will reflect the most recent exam.

If form requested is not the State of Maryland, send form to:  www.pediatricmedicine06@gmail.com

Pre-Op and Procedure Form

20

Must have facility approved form.  Send form to:  www.pediatricmedicine06@gmail.com

Lead Test Form

10

Requires a lab test after the age of 9 months.  If form requested is not the State of Maryland, send form to:  www.pediatricmedicine06@gmail.com

College Entry Form or Information Request

20

College Form or Information Request

Must have college forms brought to the office with child.

Form or information may be sent to:  www.pediatricmedicine06@gmail.com

Some forms may require a recent physical exam and/or lab work. Please arrange for an appointment or necessary lab work. If form requested is not the State of Maryland, send form to: www.pediatricmedicine06@gmail.com

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