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Forms and Policies
Record Release Authorization
Please use this form to request that a copy of your medical records or your child's medical records are forwarded to the Whole Child Center.
After downloading and completing the form, please send it directly to your child's existing doctor's office, NOT to the Whole Child Center.
For all new patients, you may download our office policies form to review and complete prior to your visit. Please bring it with you to your appointment.
This form describes our privacy policy.
Vaccine Information Statements
We strongly support informed consent with regard to all medical
procedures in our office, including immunization. To review CDC Vaccine
Information Statements listing risks and benefits of particular
vaccines, please visit http://www.immunize.org/vis. We also encourage
you to discuss each and every vaccine with us at your well care visits.
NJIIS Vaccine Registry Notice
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