Child Medical Statement   

This form needs completed by your family physician or your child’s pediatrician.  The child’s immunization chart needs to accompany this form.

Child Medical Statement

Looking for a Pediatrician? We HIGHLY recommend the Christian Practice:

Visit their page at http://www.ohiopediatricians.com or call them at:

419.524.1085 Mansfield Office

419.207.1085 Ashland Office