Sports Physical Forms
What to Expect at Visits
Save time in appointments by printing and completing the highlighted forms associated with each visit before you arrive!
- Anxiety visit GAD-7 Anxiety Scale
- ADHD visit
ADHD Rating Scale-IV: Home Version
ADHD Rating Scale-IV: School Version
- Asthma visit
ACT form Ages 4-11
ACT form Ages 12+
As pediatricians, one of the most important parts of our job is making sure that kids get all of their vaccinations. Vaccines are safe and effective. The Department of Pediatrics at UVMHN Porter Medical Center strongly recommends that our patients receive all recommended vaccines on the schedule recommended by the CDC and endorsed by the American Academy of Pediatrics.
While our recommendation is firm, we recognize that some families have questions or concerns about vaccinations, and we welcome and encourage those discussions. Through these conversations, we can address these concerns, provide accurate, evidence-based information about vaccine safety and work together to come up with a plan for vaccination.
Our intent is not to exclude any family or patient from our practice based on vaccination decisions, however we do need to consider the health and safety of all of our patients. In the event that a family opts to decline all vaccinations, or declines vaccines for particularly contagious diseases such as measles, part of our discussion will include whether or not our practice is the right place for your child’s care. To help in this decision, we have formed the Department of Pediatrics Vaccine Counsel, which is a group of providers and staff from both practices that will meet with families on a case by case basis to help make impartial, fair recommendations for whether or not we can continue to care for an un- or under-vaccinated child, and if so, whether any special precautions need to be taken when those children need medical care.
We welcome your thoughts, questions and feedback, so please do not hesitate to contact your provider’s office if you would like to discuss this policy further.
A late patient is someone who presents after more than 50% of their scheduled appointment. Of note, a patient will not be considered a no-show, or cancelled patient if they arrive late for their appointment. Clinic staff will make every effort to offer the following options in accordance with UVM Medical Group Practice Standards:
- Patient is informed of the clinic schedule and told when they can be seen.
- Patient may be seen for a portion of their appointment and rescheduled for the second portion (i.e.: initial 60 minute antenatal visit).
- Patient may be seen at the end of the clinic session.
- Patient may be offered another provider depending on availability.
- Patient may be rescheduled at a convenient time for the patient.
Prescriptions & Refills
How can I refill my medication?Medication refill requests can be made online through MyChart. See information above to sign up or log in.
Refills can also be made by contacting your pharmacy. This applies to controlled substances and applies if you have no refills left on your bottle(s). Your pharmacy will contact us with your medication needs.
Refill requests take 48 to 72 hours (or 3 business days) to process. Requests made on a Friday will be processed the next business day. Unfortunately, we cannot process refill requests over the weekend.
Can I use a Mail Order Pharmacy?For our office to send scripts to your mail order pharmacy we will need you to contact the insurance company that you have the pharmacy benefits with. (The phone number should be on the back of your card.) Please let us know which Mail Order Pharmacy you will be using with your medications.
What if my prescription is a Controlled Substance?Controlled substances are prescribed electronically, but there are restrictions on how they are refilled. Please call us at (802) 388-7959 or submit a refill request via MyChart when you need a refill, allowing at least 72 hours for the refill request to be processed whenever possible. We are also required to have a Controlled Substance Agreement form signed on a yearly basis for patients who are taking medications that are controlled substances.
Will someone remind me of my visit?As a service to our patients, we have implemented an appointment reminder system, HouseCalls, to provide you with the courtesy of a timely reminder of your next scheduled appointment. Patients have the options to choose a CALL or TEXT preference…
If you are unavailable when the call is made and have voicemail or an answering machine, the system will leave you a brief message.
- HouseCalls will CALL or TEXT you 2 days prior to give you the day, date and time of your appointment.
- For TEXT reminders, you can reply to the instructions on the screen to confirm or cancel.
- For CALL reminders, you can either confirm or cancel the appointment by using your telephone keypad.
- Press the 1 Key to confirm the appointment
- Press the 2 Key to repeat the message
- Press the 3 Key to cancel the appointment
What if I can’t make it to my appointment?If you should need to cancel and/or reschedule your appointment, please call us at 802-388-7959. We require 24 hours notice for all cancellations. If you do not call us in advance of your appointment time, you will be considered a “No Show”. Please review our No Show and Cancellation Policy for more information.
What should I bring to my appointment?Please bring your insurance card and photo ID with you to your appointment. When you check in, notify us of any changes in your insurance coverage.
When can I expect my test results?Our policy is to notify patients of all test results, either by phone or by mail. Unless there is an unanticipated abnormal result or one that requires urgent attention, it may be up to 10 days for you to get your results, longer for some tests. Be assured that all tests are reviewed for urgency by a clinical staff member as soon as we receive them, even if the ordering provider is not immediately available. Test results are available in MyChart. Please do not call for results unless you have not heard from us by 2 weeks after the test was performed.
Can I view my test results online?Yes! Test results are available in MyChart. Be assured that all tests are reviewed for urgency by a clinical staff member as soon as we receive them, even if the ordering provider is not immediately available. Please do not call for results unless you have not heard from us by 2 weeks after the test was performed. Please be sure to register for MyChart in person before attempting to log in.
Referrals to other Providers
What should I do if I’m referred to another provider?If your provider has determined that you must be seen by an outside specialist, i.e., cardiologist, podiatrist, etc., we can make that appointment for you and call with the information. We will send appropriate medical records required for your care to the specialist. You may also require an insurance referral. Depending upon your insurance, pre-certification/prior authorization may need to be completed in order for your insurance company to pay for those visit(s).
What if my visit is covered by Workers Compensation?Please provide the date of injury, employer, and worker’s comp liability insurance. Failure to provide this information at the time of your visit will result in the bill being sent to you as a “self pay”. You will then be responsible for submitting the bill for payment.
Medical Records & Patient Confidentiality
Does the Electronic Medical Record compromise my privacy?It is our responsibility to protect the confidentiality of your medical records at all times. Records may only be released with the written consent of the patient or the patient’s legal guardian. If at any time you feel your privacy has been violated, please contact Customer Service at 802-388-5699.
Can I transfer my records?If you would like your records transferred, you must sign a release statement giving us permission to share your records or send information to another office. It usually takes 30 days to transfer/copy your medical records. Medical Records Release Form.
What if I can’t pay my bill?If you are unable to pay your bill you may be eligible for financial assistance. You can obtain this information by contacting our Patient Financial Services department at 802-388-5673 or 802-388-4745.
General billing questions may be directed to the appropriate members of our Financial Services staff at the listing below:
Patient Financial Services
37 Porter Drive Middlebury, VT 05753
Chris Cook, Director Porter Financial Services