Primary Care, Chadds Ford

Health Form Requests

We will complete health forms at your child’s well visit at no additional charge.
There is a $5.00 cash or check charge for each health form to be completed (other than at a well visit).
Driver’s Permit Physical Examination forms will be completed free of charge, but the patient must be present to sign the form in front of the physician. Please call the office in advance for a time that is mutually convenient for this meeting.
There is no charge for copies of immunization records.
Please remember that a physical exam in the last year is required for the completion of any form. If it has been more than 6 weeks since the date of that exam, the parent/guardian will be required to complete our Interim Health Form to bring the provider up to date on any recent clinical changes in the patient.
Allow our office 5 business days to complete health forms.

Call Chadds Ford

1766 Wilmington Pike

Glen Mills PA, 19342

610-358-3508

Main Number: 215-590-1000
Physician Referral Service: 1-800-879-2467
Coordinates: 39.9486937, -75.1929596
An Equal Opportunity Employer
The Children's Hospital of Philadelphia is an equal opportunity employer. We do not discriminate on the basis of race, color, gender, sexual orientation, age, religion, national or ethnic origin, disability or veteran status.