Early childhood: 1 to 5 years

To make the most of our time together, please remember to:

Parent Questionnaire: print a copy, fill it out and bring it to the well care visit.
Parent Checkup Information: read the information and write down any questions you would like to discuss.
Immunization Records: bring to the visit so we can update them.
Please note: To view and print the documents below you need Adobe Acrobat Reader. You can click on the link to download Adobe Acrobat Reader if needed.

If your child is 12 or 13 months old, open and print the following two forms:
12 month - Well Check Health Questionnaire [English/Spanish](Parent questionnaire -- please print, fill out and bring to the well care visit)
12 Month Checkup (Information sheet -- read and write down any questions you have)

If your child is 14 to 16 months old, open and print the following two forms:
14-15 Month - Well Check Health Questionnaire [English/Spanish] (Parent questionnaire -- please print, fill out and bring to the well care visit)
14 to 15 Month Checkup (Information sheet -- read and write down any questions you have)

If your child is 17 to 20 months old, open and print the following two forms:
18 Month - Well Check Health Questionnaire [English/Spanish] (Parent questionnaire -- please print, fill out and bring to the well care visit)
18 Month Checkup (Information sheet -- read and write down any questions you have)

If your child is 21 months to 2 1/2 years old, open and print the following two forms:
21 to 24 Month - Well Check Health Questionnaire [English/Spanish] (Parent questionnaire -- please print, fill out and bring to the well care visit)
21 to 24 Month Checkup (Information sheet -- read and write down any questions you have)

If your child is 2 1/2 through 3 years old, open and print the following two forms:
3 Year - Well Check Health Questionnaire [English/Spanish] (Parent questionnaire -- please print, fill out and bring to the well care visit)
3 Year Checkup (Information sheet -- read and write down any questions you have)

If your child is 4 years old, open and print the following two forms:
4-5 Year - Well Check Health Questionnaire [English/Spanish] (Parent questionnaire -- please print, fill out and bring to the well care visit)
4 to 5 Year Checkup (Information sheet -- read and write down any questions you have)

If your child is 5 or 6 years old, open and print the following two forms:
5 to 6 Year - Well Check Health Questionnaire [English/Spanish] (Parent questionnaire -- please print, fill out and bring to the well care visit)
5 to 6 Year Checkup (Information sheet -- read and write down any questions you have)