• Make an Appointment
  • Locations
    • Doddridge SBHC
    • Ellenboro SBHC
    • Harrisville
    • Jefferson SBHC
    • Parkersburg South SBHC
    • Smithville SBHC
    • St. Marys SBHC
    • West Union
  • Services
    • Telehealth
    • Online Consent Forms
    • Need a Ride?
    • COVID-19 >
      • COVID Vaccines & Treatment
      • COVID Vaccine Due Date Calculator
  • Patient Portal
  • Blog
  • Contact
  • More
    • Staff
    • Careers
    • Immunizations Information
RITCHIE REGIONAL HEALTH CENTER
  • Make an Appointment
  • Locations
    • Doddridge SBHC
    • Ellenboro SBHC
    • Harrisville
    • Jefferson SBHC
    • Parkersburg South SBHC
    • Smithville SBHC
    • St. Marys SBHC
    • West Union
  • Services
    • Telehealth
    • Online Consent Forms
    • Need a Ride?
    • COVID-19 >
      • COVID Vaccines & Treatment
      • COVID Vaccine Due Date Calculator
  • Patient Portal
  • Blog
  • Contact
  • More
    • Staff
    • Careers
    • Immunizations Information

Online Consent Forms

It's free, easy, and secure!
Unable to fill out a paper copy? Don't have a printer? Maybe you just want to save paper. Whatever the reason, RRHC has you covered! Simply scan the QR code or click on the form's title and complete it. Contact your local Ritchie Regional campus with any questions.

Sports Physical Form (https://form.jotform.com/223216326034041)
​
This form is required each school year on or after May 1 and was created in accordance with the West Virginia Secondary School Activities Commission (WVSSAC). 
Picture
To print a copy of the sports physical form, download the form:
revised_sports_physical_form_5.23.pdf
File Size: 2123 kb
File Type: pdf
Download File


Immunizations Consent Form (https://form.jotform.com/231024654317045​)
​
This form should only be completed AFTER contacting us to confirm the necessary vaccine(s) for your child. To view a typical immunization schedule and/or to see West Virginia immunization requirements for school entry, visit our Immunizations Information page.
Picture
The first PDF is the RRHC Controlled Substance Agreement. The second PDF contains an information statement for each vaccine (the Vaccine Information PDF is in alphabetical order).
controlled_substance_agreement.pdf
File Size: 443 kb
File Type: pdf
Download File

vaccine_infomation__alphabetical_.pdf
File Size: 1449 kb
File Type: pdf
Download File


We're open! Find a RRHC location near you.

FIND A LOCATION
Picture
Picture

Quick Links


Locations
Telehealth
Staff​
Request an Appointment
Self-Scheduler (returning patients ONLY)
Make a Payment
Patient Portal

Contact Us


Administrative Office:
​PO Box 373
135 South Penn Ave.
Harrisville, WV 26362
304-643-4005

Notice


RRHC is a Health Center Program grantee under 42 U.S.C. 254b, and a deemed Public Health Service employee under 42 U.S.C. 233(g)-(n). It is an FTCA deemed facility, covered by professional liability insurance through our enrollment in Federal Tort Claims Act program.

© Copyright 2020, All Rights Reserved.  |  Privacy Policy  |  Terms & Conditions  |  Employee Outlook Login
Site by Skiilight Interactive
  • Make an Appointment
  • Locations
    • Doddridge SBHC
    • Ellenboro SBHC
    • Harrisville
    • Jefferson SBHC
    • Parkersburg South SBHC
    • Smithville SBHC
    • St. Marys SBHC
    • West Union
  • Services
    • Telehealth
    • Online Consent Forms
    • Need a Ride?
    • COVID-19 >
      • COVID Vaccines & Treatment
      • COVID Vaccine Due Date Calculator
  • Patient Portal
  • Blog
  • Contact
  • More
    • Staff
    • Careers
    • Immunizations Information