Common Forms and Handouts

Here are some common forms and handouts, including referral information, lab and radiology facilities, and information on common concerns and frequently asked questions.

Referrals

• Specialists List (updated on March 4th, 2019)
• Labs and Radiology Facilities

Front Desk Forms

• Authorization for Medical Treatment
• Authorization for Release of Confidential Health Information (Records Release) 

If you require assistance transferring your records to or from our office, please contact Maria in the records department at 407-916-4520 or maria@rdvpediatrics.com. Please note that all records are available at no charge on the Patient Portal.

Patient Educational Handouts

• Tylenol Dosage Chart
• Motrin Dosage Chart *for babies 6 months and up only
• Post-Immunization Reactions
• Our Vaccine Schedule
• Feeding Your Baby FAQ
• Non-Dairy Calcium Containing Foods

Patient Questionnaires & Screenings

• 12 Month Ages & Stages Questionnaire *must log in to Portal to access
• 18 Month Ages & Stages Questionnaire *must log in to Portal to access
• 24 Month Ages & Stages Questionnaire *must log in to Portal to access
• 30 Month Ages & Stages Questionnaire *must log in to Portal to access
• Lead Screening *6mos, 9mos, 12mos, 18mos, 24mos, 3yrs, 4yrs, 5yrs