Forms
There are a number of forms you might need to submit for your child – for school, sports, camps, and for administration of medication. We also have forms that we ask parents to fill out, such as our family registration form, which is used to keep contact and insurance information current. To make this process as simple as possible we have made many forms available for downloading. Please feel free to use them as needed. Also, please note that we cannot offer completed health forms online.
At the time of your child’s yearly physical exam you will receive a standard State of Connecticut school form. Please keep the original for school and make copies to attach to any additional forms you might need, such as for camp. If you need a form filled out on an “emergency” basis, or need extra forms, there will be an additional charge. We appreciate your patience during the busy time of the year for forms – we want to make your “forms” experience as efficient and pleasant as possible!
Connecticut Sports Participation Form
State of Connecticut Sports Form
Connecticut School Forms
Connecticut State Elementary, Middle, and High School Form
PLEASE NOTE: Blue Paper Required
Connecticut State Pre-School Form
PLEASE NOTE:Yellow Paper Required
Willows Forms
2023-4 Injectable Flu Shot Administration Form
Willows Pediatrics Family Registration Form
Medication Administration Form
Authorization to Release Medical Records
Acknowledgement of Receipt of Privacy Policy