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.

School Forms

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 doctors@foxhallpediatrics.com 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.

Development Concerns?

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.

Disclaimer: This website is designed for general educational and information purposes only and does not render medical advice, opinion, or professional services. The information provided on this website may not be used for diagnosing or treating a health problem or disease of any sort and cannot be used as a substitute for consultation with a medical professional. Foxhall Pediatrics accepts no responsibility for such use of the information provided herein. If you have or suspect you may have a health problem, you should consult a medical professional. If you think you may have a medical emergency, call Emergency Medical Services (911) immediately. All links from this website are provided for information and convenience only. We do not accept responsibility for sites linked to.