MY KID'S CHART
Prenatal and Newborn
Sports and School Physicals
FORMS & POLICIES
Required Registration Forms
Patient Registration Form
General Office Policies
HIPAA (Notice of Privacy Practices)
Authorization to Release Medical Records/Information
CHADIS (Child Health & Development Interactive System)
Only one form is necessary for each family.
Why do I need to fill out
How do I access CHADIS?
(First Time User Only)
First time users, click the above link
Input the invitation code: 7038655437
Create your user ID and Password
(Registered User Only)
If you have already registered,
click the above link
Authorization of Delegate - Adult
When patient is 18 or older and wants to authorize access of his/her info or act on his/her behalf (i.e. parent, grandparent).
Authorization of Delegate - Minor
For legally authorized patient representatives (parent/guardian) of a patient under 18 to delegate another person to act on the representative's behalf (i.e. grandparent, aunt).
Childhood Immunization Q&A
AAP Vaccine Safety Fact Sheet
Vaccine Administration Consent Form
Vaccine Administration Refusal Form
Virginia School Entrance Form
Virginia High School Sports Form