These forms are available for download in .pdf format. To download forms, simply click on your choice and after the form opens, select the Print option.
New Patient Request Form
Medical Records Request Form – Sharecare
Medical Information Release Form
Ardmore Family Practice Registration Packet
Information Regarding Sports and Kindergarten Physicals
Sports and Camp Physicals
Forsyth County Schools and surrounding counties require children trying out for school sports to have a physical exam annually. Camps and day cares may also require physical exams every one or two years. Even though we may see your child for other reasons throughout the year, these visits are not considered complete physicals and cannot be used to complete your child’s form. If your child desires to participate in school sports or attend camp, and if a physical is needed, please call early to schedule an appointment. If your child has had a recent physical, in the last 6 – 8 months, we can complete your form for $15.00.
School systems in this area require that all children receive a complete physical within 365 days of starting kindergarten. This consists of obtaining height, weight, blood pressure, vision screen, audiogram, labwork, and updating immunizations. Each county provides a form for the physician’s office to complete which should be returned to your child’s school after the physical exam. Please bring this form with you to the visit. If the physical is not performed before school begins, you will have a thirty day grace period to have an examination and complete the form. These appointment slots fill up quickly, so please call early to schedule your child’s examination.
Pilots who need medical certificates, visit https://medxpress.faa.gov.
Need Us? Call Our Office at: 336-659-0076
Ardmore Family Practice
2805 Lyndhurst Avenue
Winston Salem, NC 27103
Monday - Friday
8:00am - 5:00pm
Closed 12:00pm - 1:00pm for lunch
9:00am - 12:00pm
Ardmore Family Practice *2021