Well Check Forms

You will find information that we hope will be helpful to your child’s care in our practice. This page should provide you with information regarding Well Check visits. Below are some forms that may apply to your childs well child check or consultation appointment. If you'd like to print and fill them out in advance, this may speed up your check in process. Or you are welcome to wait until your appointment and we will provide you with them. We hope this helps make your visit with our office much more pleasant:

Well Check Forms

ATTENTION: Group Health or Private Insured Patients                                                                   Please contact your insurance company prior to your visit to discuss your well-care benefits. Please do not rely on Pediatric Associates for this information, as most insurance requirements are different. Also, please ask your insurance carrier if they provide coverage for immunizations, as you will be required to sign a waiver of responsibility prior to your child's check-up. If your insurance carrier does not provide coverage for immunizations, and we are notified prior to administration, we will be able to provide these at a discounted cost to you. However, we are unable to make adjustments after the service has been provided.

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Lab Info                                                                                                                                                     After your child's two year check up, labs are drawn every even year (e.g. 2yr, 4yr, 6yr, etc). For accurate lab results, please be sure that your child DOES NOT EAT OR DRINK anything one hour prior to your scheduled check-up.

                                  *No eating 1 hour before your check up*

Your assistance is appreciated!