Patient Portal FAQ
Forms and Policies
Effective October 1, 2016, Dothan Pediatric Clinic will charge for the completion of forms when not completed at the time of service.
As an alternative you can use your patient portal account to request forms at NO CHARGE. If you do not have a patient portal account, please call us at (334) 793-1881 ext 2699.
School Medication Forms
School Excuses for Past Visits
Patient Profile for Social Security
LIHEAP - Power Assistance
An additional $20 will be charged for forms completed the same day (LIHEAP not applicable).
View Medical Release Form
Alabama High School Athletic Association - Sports Physical Form
Florida Sports Physical Form
FT Rucker Sports Physical Form
Georgia - Sports Physical Form
Medical Release Form