3 to 10 Years
Well Visit Paperwork
To help paint a complete picture of your child's health and development, please fill out these forms and bring them with you to each well visit.
Please fill out parent portion of the form, including the demographic information, and bring it with you to your child's visit. Please note that some forms require a parent authorization via signature on the form for us to release your child's confidential health information to your school or camp. You can also email the form to firstname.lastname@example.org it to the office prior to the visit. Please confirm that the correct form is completed, as not all schools accept the general DC, MD or VA forms.
If you have any concerns about your child’s speech, social or motor skills, please complete the “Ages and Stages Questionnaire” appropriate for their age and bring it to their Well Child Visit.