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165 Log Canoe Circle, Suite E
Stevensville, MD 21666
Phone:
410-643-1000
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Forms
For added convenience, our forms can be downloaded and saved for future use. To download, simply click below.
New Patient Forms
New Patient Packet (PDF)
Patient Request for Records (PDF)
Parent/Guardian Consent for Medical Treatment (PDF)
Newborn Forms
Newborn Packet (PDF)
School Forms
Lead Testing Form (PDF)
Maryland School Health Form (PDF)
Medication Form (PDF)
Additional Forms
Day Care Health Inventory Form (PDF)
Request for Forms Completion (PDF)
Adult ADHD (PDF)
Telehealth
Telehealth Consent (PDF)
Adobe Acrobat Reader is required to open these forms -
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Is Your Child Sick?
®
Medical Articles
Illnesses and Symptoms...
Abdominal Pain - Female
Abdominal Pain - Male
Acne
Animal or Human Bite
Antibiotics: When Do They Help?
Anxiety Attack
Arm Injury
Arm Pain
Asthma Attack
Athlete's Foot
Back Pain
Bed Bug Bite
Bee or Yellow Jacket Sting
Behavioral Health Problems
Blisters
Boil
Bottle-Feeding (Formula) Questions
Breast Symptoms-Child
Breast Symptoms-Teen
Breast-Feeding Questions
Breath-holding Spell
Breathing Trouble
Bronchiolitis-RSV
Bruises and Cuts
Burn
Chest Pain
Chickenpox
Circumcision Problems
Colds
Colds (0-12 Months)
Constipation
Cough
Cough (0-12 Months)
Coughs: Meds or Home Remedies?
COVID-19 Diagnosed or Suspected
COVID-19 Exposure, But No Symptoms
COVID-19 or Influenza - How to Tell
Cracked or Dry Skin
Cradle Cap
Croup
Crying Baby - Before 3 Months Old
Crying Child - 3 Months and Older
Cut, Scrape, or Bruise
Depression
Diaper Rash
Diarrhea
Diarrhea (0-12 Months)
Diarrhea Diseases From Travel
Dizziness
Drinking Fluids - Decreased
Dry Skin
Ear - Congestion
Ear - Discharge
Ear - Pulling At or Rubbing
Ear - Swimmer's
Ear Infection Questions
Ear Injury
Ear Piercing Symptoms
Earache
Earwax Buildup
Ebola Exposure
Eczema
Emergency Symptoms Not to Miss
Eye - Allergy
Eye - Foreign Object
Eye - Pus or Discharge
Eye - Red Without Pus
Eye Injury
Eye Swelling
Fainting
Fever
Fever - How to Take a Temperature (0-12 Months)
Fever - How to Take the Temperature
Fever - Myths Versus Facts
Fever (0-12 Months)
Fifth Disease-Viral Rash
Finger Injury
Fire Ant Sting
Flu
Fluid Intake Decreased
Food Allergy
Foreskin Care Questions
Frostbite
Genital Injury - Female
Genital Injury - Male
Hair Loss
Hand-Foot-and-Mouth Disease-Viral Rash
Hay Fever
Head Injury
Head Lice
Headache
Heat Exposure and Reactions
Heat Rash
Hives
Hoarseness
Human or Animal Bite
Immunization Reactions
Impetigo - Infected Sores
Infection Exposure Questions
Influenza - Seasonal
Influenza Exposure
Insect Bite
Jaundiced Newborn
Jellyfish Sting
Jock Itch
Leg Injury
Leg Pain
Lice - Head
Lymph Nodes - Swollen
Medicine - Refusal to Take
Menstrual Cramps
Menstrual Period - Missed or Late
Mental Health Problems
Molluscum-Wart
Mosquito Bite
Mosquito-Borne Diseases from Travel
Motion Sickness
Mouth Injury
Mouth Ulcers
Neck Pain or Stiffness
Newborn Appearance Questions
Newborn Illness - How to Recognize
Newborn Rashes and Birthmarks
Newborn Reflexes and Behavior
Nose Allergy (Hay Fever)
Nose Injury
Nosebleed
Panic Attack
Penis-Scrotum Symptoms-Child
Penis-Scrotum Symptoms-Teen
Pinworms
Poison Ivy - Oak - Sumac
Puncture Wound
Rash or Redness - Localized
Rash or Redness - Widespread
Reflux (Spitting Up)
Ringworm
Roseola-Viral Rash
RSV-Bronchiolitis
Scabies-Itch Mite Rash
Scorpion Sting
Scrape
Sexually Transmitted Infections
Sinus Pain or Congestion
Skin Foreign Object
Skin Injury
Skin Lump
Sliver or Splinter
Solid Foods (Baby Foods)
Sore Throat
Spider Bite
Spitting Up - Reflux
STI Exposure
Stomach Pain - Female
Stomach Pain - Male
Stools - Blood In
Stools - Unusual Color
Strep Throat Exposure
Strep Throat Infection
Sty
Sunburn
Suture Questions
Swallowed Foreign Object
Swallowed Harmless Substance
Swimmer's Itch - Lakes and Oceans
Tear Duct - Blocked
Teething
Thrush
Tick Bite
Toe Injury
Toenail - Ingrown
Tooth Injury
Toothache
Trouble Breathing
Umbilical Cord Symptoms
Urinary Tract Infection - Female
Urination Pain - Female
Urination Pain - Male
Vaginal Bleeding
Vaginal Symptoms-Child
Vaginal Symptoms-Teen
Vomiting (0-12 Months)
Vomiting With Diarrhea
Vomiting Without Diarrhea
Warts
Weakness and Fatigue
Wheezing (Other Than Asthma)
Wound Infection
Medical Articles
Medicine Dosages...
Acetaminophen (brand name Tylenol)
Answers About Complementary and Integrative Medicine—Autism Toolkit
Benadryl (generic name diphenhydramine)
Choosing Over-the-Counter Medicines for Your Child
Complementary and Integrative Medicine: What Parents Need to Know
Giving Eye drops to your Toddler
Giving Medicine to Children: Important Safety Information
How Asthma Medicines Are Taken
Ibuprofen (brand name Advil or Motrin)
Medications, Administration of
Medicine and the Media: How to Make Sense of the Messages
Prescription Medicines and Your Child
Use of Medicines in Sports (Care of the Young Athlete)
Using Liquid Medicines
Using Over-the-Counter Medicines with Your Child
Medical Articles
Medical Conditions...
Acute Ear Infections and Your Child
Allergies in Children
Anaphylaxis
Anemia in Children and Teens
Anesthesia and Your Child: Information for Parents
Ankle Sprain Treatment (Care of the Young Athlete)
Antibiotics Aren't Always Needed
Anxiety
Appendicitis
Asthma
Asthma and Your Child
Asthma Triggers
Bedbugs—Child Care and Schools
Bedwetting
Bedwetting
Bites (Human and Animal)—Child Care and Schools
Boil/Abscess/Cellulitis—Child Care and Schools
Breastfeeding During the COVID-19 Pandemic
Breath-Holding Spells
Bronchiolitis and Your Young Child
Campylobacter—Child Care and Schools
Chickenpox (Varicella-Zoster Infections)—Child Care and Schools
Clean Intermittent Catheterization for Boys
Clean Intermittent Catheterization for Girls
Clostridium difficile (Also Called “C diff”)—Child Care and Schools
Common Childhood Infections
Congenital Hip Dysplasia
Constipation and Your Child
Co-Parenting Through COVID-19: Putting Your Children First
COVID: How to Prepare for Your Child’s COVID Vaccination
COVID-19: Caring For Children and Youth With Special Health Care Needs
COVID-19: Keep On Keeping Your Distance
COVID-19: What Families Need to Know
Croup
Croup and Your Young Child
Croup: When Your Child Needs Hospital Care
Crying and Your Baby: How to Calm a Fussy or Colicky Baby
Cryptosporidiosis—Child Care and Schools
Cytomegalovirus (CMV) Infection—Child Care and Schools
Depression
Developmental Dysplasia of the Hip
Diaper Rash and Your baby
Diarrhea and Your Child
Diarrhea Caused by Specific Types of E coli (Escherichia coli)—Child Care and Schools
Diarrhea—Child Care and Schools
Ear Infection—Child Care and Schools
Eating Disorders
Eating Disorders: Anorexia and Bulimia
Eczema (Atopic Dermatitis) and Your Child
Face Masks for Children During COVID-19
Febrile Seizures
Fever and Your Child
Fever—Child Care and Schools
Fifth Disease
Fifth Disease (Human Parvovirus B19)—Child Care and Schools
Food Allergies and Your Child
Food Borne Illnesses
Gastroenteritis, Viral
Gastroenteritis: When Your Child Needs Hospital Care
Getting Children and Teens Outside While Physical Distancing for COVID-19
Giardiasis—Child Care and Schools
Haemophilus influenzae Type b (Hib)—Child Care and Schools
Hand Foot and Mouth
Hand-Foot-and-Mouth Disease—Child Care and Schools
Head Lice
Head Lice: What You Need to Know
Hepatitis A Infection—Child Care and Schools
Hepatitis B Infection—Child Care and Schools
Herpes Simplex (Cold Sores)—Child Care and Schools
Hip Dysplasia (Developmental Dysplasia of the Hip)
HIV and AIDS: What You Need to Know
HIV/AIDS—Child Care and Schools
How to Take Your Child's Temperature
Imaging Tests: A Look Inside Your Child's Body
Immunizations
Impetigo—Child Care and Schools
Influenza (Flu): What You Need to Know
Influenza—Child Care and Schools
Inhaled and Intranasal Corticosteroids and Your Child
Lead Poisoning
Learning Disabilities: What Parents Need to Know
Lice (Pediculosis Capitis)—Child Care and Schools
Lyme Disease
Lyme Disease (and Other Tick-borne Diseases)—Child Care and Schools
Managing Chronic Health Needs in Child Care and Schools—Allergic Skin Conditions
Managing Chronic Health Needs in Child Care and Schools—Allergies: An Overview
Managing Chronic Health Needs in Child Care and Schools—Anaphylaxis
Managing Chronic Health Needs in Child Care and Schools—Asthma
Managing Chronic Health Needs in Child Care and Schools—Attention-Deficit/Hyperactivity Disorder (ADHD)
Managing Chronic Health Needs in Child Care and Schools—Gastroesophageal Reflux Disease (GERD)
Measles—Child Care and Schools
Meningitis—Child Care and Schools
Mental Health
Middle Ear Fluid and Your Child
Molluscum Contagiosum—Child Care and Schools
Monkeypox: What You Need to Know
Mononucleosis—Child Care and Schools
Mosquito-borne Diseases—Child Care and Schools
Mouth Sores—Child Care and Schools
Mumps—Child Care and Schools
Norovirus—Child Care and Schools
Osgood-Schlatter Disease (Care of the Young Athlete)
Parasites - Giardia
Parenting in a Pandemic: Tips to Keep the Calm at Home
Pinkeye (Conjunctivitis)—Child Care and Schools
Pinkeye and Your Child
Pinworms—Child Care and Schools
Pneumonia and Your Child
Pneumonia—Child Care and Schools
Protecting Your Child With the COVID-19 Vaccine
Respiratory Syncytial Virus (RSV)
Respiratory Syncytial Virus (RSV)—Child Care and Schools
Ringworm—Child Care and Schools
Roseola (Human Herpesvirus 6 and 7)—Child Care and Schools
Rotavirus
Rotavirus—Child Care and Schools
Rubella (German Measles)—Child Care and Schools
Safety of Blood Transfusions
Salmonella—Child Care and Schools
Scabies—Child Care and Schools
Shigella—Child Care and Schools
Shingles (Herpes Zoster)—Child Care and Schools
Simple Ways to Entertain and Boost Your Baby’s Development at Home
Sinusitis and Your Child
Sleep Apnea and Your Child
Staphylococcus aureus (Methicillin-Resistant [MRSA] and Methicillin-Sensitive [MSSA])—Child Care and Schools
Strep Throat (Streptococcal Pharyngitis) and Scarlet Fever—Child Care and Schools
Sty—Child Care and Schools
Teens & COVID-19: Challenges and Opportunities During the Outbreak
Thrush (Candidiasis)—Child Care and Schools
Tips for Coping with a New Baby During COVID-19
Tonsils and Adenoid
Toxoplasmosis
Treating Your Child's Pain: Medical Procedures
Treating Your Child's Pain: Surgery
Tuberculosis (TB)—Child Care and Schools
Type 2 Diabetes: Tips for Healthy Living
Upper Respiratory Infection (Common Cold)—Child Care and Schools
Urinary Tract Infection—Child Care and Schools
Urinary Tract Infections in Young Children
Vomiting—Child Care and Schools
Warts (Human Papillomavirus)—Child Care and Schools
Whooping Cough (Pertussis)—Child Care and Schools
Working and Learning from Home During the COVID-19 Outbreak
Your Child Has a Sore Throat: What's the Cause?
Your Child’s Sleep Diary
What's Going Around?
Office Hours
Monday 8am to 5pm
Tuesday 8am to 5pm
Wednesday 8am to 5pm
Thursday 8am to 5pm
Friday 8am to 4pm
Saturday 9am to 1pm
Sunday we are Closed
Medical Information
Behavior
Breast Feeding
Emergencies
Newborns
Nutrition
Parenting Tips
Safety
Special Needs
Growth & Development
Sports & Exercise
Teens
Mental Health