Important Forms
New Patients
- Please fill out and bring the registration form and the Patient Medical History Form to your child's first appointment. You will need to print the forms off before filling them out.
Current Patient Forms
TPG Forms:
2012 Registration Form
HIPAA Acknowledgement form
Patient Medical History Form
School Forms
Fairfax County:
Health and Medical Forms
High School Athletic Form
Alexandria City:
School Health Entrance Instructions and Form (186K PDF)
Inhaler Authorization Form (54K PDF)
Medication Authorization Form (70K PDF)
Authorizacion Para Administrar Inhalador (57K PDF)
Authorizacion Para Administrar Medicacion (78K PDF)
Prince William County:
Prince William County School Health Forms and Regulations
TB Regulations and Form
Physical Examinations
Allergic Reaction Form
Virginia School Form
Administering Medication
Administering Medication
Asthma Medication
Insulin & Glucagon Medication
TPG ANNOUNCEMENTS
Patient Portal
Our goal is to provide our patients with the best experience possible when interacting with our providers and staff. Starting in late spring, our web-based patient portal will allow you to simply and securely fill out registration forms, pay your bill on-line, and update contact and insurance information. Please use the "Contact Us" feature above to receive an invitation to sign up for our portal later this spring.
KidsDoc Symptom Checker App
The American Academy of Pediatrics has a KidsDoc Symptom Checker App for iPhone and Android. This app has a symptom care guide including appropriate homecare measures to take and advice on when it is necessary to call our overnight Triage service to seek help for your child. This can be a great tool to use when your child is sick in the middle of the night or when you are on the go.
Did you know we have a Facebook page? We have announcements, health and safety information, and any office closures listed there. Please "Like" us to get updates.