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Camp and Sports Forms Policy
It’s camp and sports form season!
During the spring and summer, especially, we have an abundance of requests for camp and sports forms to be completed. We receive many, many forms per day and it’s an all hands operation to get them completed in a timely fashion. We work on these in between patients, our regular duties and well into the night. The price this year is $10 per form.
Here’s what you can do to help:
Please allow a week to 10 days for your form to be completed. If you know your child is going to camp or needs a sports form, don’t wait to bring us the form!
Make sure your portion of the form is completed before you bring it to the office; that will save time since we cannot complete our portion without it!
Please provide a list of any medications with dosages that your child will be taking at school or at camp so we can confirm that nothing has changed from our records.
Divorced or Separated Parents
You may have an agreement regarding the cost of health care for the children with the other parent. That agreement is between you and we are not a party to it.
The parent who brings in the child and is requesting service is the parent who is responsible for the bill and is considered the guarantor. This may be different from the primary insurance holder. However, there is only one guarantor and unfortunately, we can only bill one person. Any cost sharing arrangements will need to be done outside of our office between the parents.
For instance, if you are the guarantor and the other parent is responsible for 30% of the cost of health care you will need to pay the office in full and collect separately from the other parent. We cannot bill the other parent for the balance. We can accept payments from multiple people for the account, but the bill for any unpaid balance will only go to one person.
Returned checks: $20 fee
Be sure to use the correct account when writing checks. If a check is returned to us from the bank you will be charged $20 in addition to the amount of the check.