Middle childhood: 6 to 12 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 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)

If your child is 7 or 8 years old, open and print the following two forms:
6 to 8 Year - Well Check Health Questionnaire [English/Spanish] (Parent questionnaire -- please print, fill out and bring to the well care visit)
6 to 8 Year Checkup (Information Sheet -- read and write down any questions you have)

If your child is 9 or 10 years old, open and print the following two forms:
8-10 Year Well Check Health Questionnaire (English/Spanish) (Parent questionnaire -- please print, fill out and bring to the well care visit)
8 to 10 Year Checkup (Information Sheet -- read and write down any questions you have)

If your child is 11 or 12 years old, years old, open and print the following two forms:
10-12 Year Well Check - Health Questionnaire [English/Spanish] (Parent questionnaire -- please print, fill out and bring to the well care visit)
10 to 12 Year Checkup (Information Sheet - read and write down any questions you have)