Fee for Forms: 

Attention Parents/Guardians:
There is a $10.00 fee for forms to be completed by a provider.  If you request the forms to be completed during any annual well visit, the fee will be waived. 

Examples of such forms are: 
1. Routine physical ("Yellow form")
2. Shot record ("Blue form")
3. Sports physical
4. Pop Warner
5. Medication forms
6. FMLA forms
7. Boy/Girl Scouts forms
8. Camp forms
9. Other

Vaccine Policy 
The providers at Volusia Pediatrics firmly believe in the effectiveness of vaccines to prevent serious illness and to save lives, and we firmly believe in the safety of our vaccines. Vaccinating children and young adults may be the single most important health-promoting intervention that we perform as health providers and that you can adhere to as parents/caregivers.

It is our responsibility to promote and protect patient health, which is why we have adopted the vaccination schedule recommended by the American Academy of Pediatrics (AAP), The National Institute of Health, and the Centers for Disease Control (CDC).  All new patients must follow the recommended vaccine schedule, though exceptions can be made if the child is ill at the time of the scheduled vaccine(s).

We respect your right in making the final decision over your children’s health. At the same time, however, we have a duty to protect the health of all our patients, including those who cannot yet be vaccinated (such as newborns). If you should refuse to vaccinate your child, we will ask you to find another healthcare provider who shares your views. We do not keep a list of such providers, nor would we recommend any such physician.

Please recognize that by not vaccinating, you are putting your child at unnecessary risk for life-threatening illness, disability and even death. As medical professionals, we feel very strongly that vaccinating your child on schedule with currently available vaccines is absolutely the right thing to do to protect all children and young adults.

Thank you for taking the time to read this policy. Please feel free to discuss any questions or concerns you may have about vaccines with any of the providers in our practice.