Maryland Foster Care Medical Exam Requirements: What the Physical Covers

The medical exam requirement for Maryland foster care catches some applicants off guard — not because the physical itself is demanding, but because it applies to more people in the household than most families expect, and because in parts of the state, scheduling it on short notice is genuinely difficult.

Who Needs a Medical Exam

Maryland's resource home licensing standards under COMAR 07.02.25 require a physical examination for all applicants and all household members. This is not limited to the primary applicant or the adults in the home — it applies to everyone.

In practice, this means:

• Both adults in a two-parent household must each complete a physical
• All adult children living in the home (18 and older) must complete one
• Children under 18 in the home do not require the same physical examination, though the licensing worker will assess the overall health and safety of the household environment

The physical must be performed by a licensed physician or nurse practitioner. It cannot be self-reported or completed by a telehealth service without a physical component.

What the Physical Examination Covers

The medical exam for foster care licensing in Maryland is not a standard annual wellness visit. The physician completing it is looking for specific things relevant to your capacity to care for children:

General health and communicable disease clearance. The exam documents that applicants are in good health and free from communicable diseases. The standard language used in COMAR is that household members must be in good enough health to provide ongoing care to a child.

Tuberculosis (TB) test. A TB test is mandatory. It is typically done as a skin test (Mantoux/PPD) or, increasingly, a blood-based IGRA test (QuantiFERON). Your physician will advise on which test they use. The result must be documented on your licensing paperwork — a verbal "it was negative" from your doctor is not sufficient.

Documentation on the licensing form. Maryland uses Form SSA 25-02 (or the equivalent form your county LDSS provides) to record the results. The physician completes and signs this form. Make sure you bring the form with you to the appointment — do not assume your doctor will have it. Print it in advance from the DHS website or obtain it from your LDSS before scheduling the exam.

Timing the Medical Exam in the Licensing Process

The medical exam typically happens during the home study phase, but there is no reason to wait until your LDSS asks for it. Once you have initiated contact with your county LDSS and received the required forms, you can schedule your physical immediately.

Scheduling proactively matters especially in rural parts of Maryland. In Western Maryland counties like Garrett and Allegany, and on the Eastern Shore in Somerset, Dorchester, and Caroline counties, access to primary care physicians is constrained. These counties are among Maryland's most underserved for healthcare density, and wait times for non-urgent appointments at primary care practices can run two to three months, especially in summer. In Somerset County specifically, the research on Maryland's licensing landscape identifies physician access as a documented barrier for prospective resource families.

By contrast, in Montgomery, Howard, or Anne Arundel counties, scheduling a physical with three to four weeks of lead time is typically feasible.

What If You Do Not Have a Primary Care Physician

Applicants without an existing primary care relationship have several options:

Urgent care centers that offer preventive care and physicals can often accommodate scheduling more quickly than primary care practices. Not all urgent care locations perform the COMAR-required physical with the TB component, so confirm this before booking.

Community health centers and FQHCs (Federally Qualified Health Centers) accept patients regardless of insurance status and often have shorter scheduling windows. Maryland has a network of FQHCs that can be located through the HRSA database.

County health departments in some Maryland jurisdictions offer adult physicals and TB testing. Call your county health department to ask whether they can complete the foster care physical and provide the necessary documentation.

The key constraint in any of these options is the signed licensing form. The provider completing the physical needs to document their findings on the COMAR-specified form. Bring the form with you regardless of which care setting you use.

TB Positive Results

If your TB test returns a positive or indeterminate result, this does not automatically disqualify you from licensing. A positive TB skin test result requires follow-up — typically a chest X-ray — to determine whether you have active tuberculosis or a latent infection. Latent TB, which means exposure to the bacterium without active disease, is common and manageable. Your physician will document the follow-up findings on the licensing form.

If you already know you have a history of positive TB tests, tell your licensing worker upfront and bring documentation of any prior treatment or follow-up to your appointment. This moves the process forward rather than creating an unexplained delay.

The Eastern Shore and Western Maryland Physician Gap

The research on Maryland's foster care landscape specifically identifies physician access on the Eastern Shore and in Western Maryland as a structural barrier that affects licensing timelines. Applicants in Easton, Salisbury, Cumberland, or Oakland should schedule their Form 25-02 physical as early as possible in the process — ideally within the first two weeks after initial contact with their LDSS.

Waiting to schedule the physical until the LDSS asks for it in month three of your application is a common and avoidable mistake. A physician appointment booked now is one less bottleneck in the final weeks of your licensing process.

For a complete checklist of required medical and background documentation — and a timeline for when to complete each step — see the Maryland Foster Care Licensing Guide.

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