Plan Your First Visit

 

Plan Your First Visit

We are excited to meet you and your child. Please let us know if there is anything we can do to make your first visit more comfortable. The below questionnaires will help you and the doctor evaluate your child's development and health. The registration and insurance forms help us get all our ducks in a row for your insurance.

Ages and Stages Questionnaire (ASQ) and Age Appropriate Activity Sheets

The ASQ is a screening tool to identify developmental delays in infants and young children during the crucial first 5 years of life. Parents complete a 30 item questionnaire which asks about a child's progress in five key developmental areas – communication, gross motor, fine motor, problem solving, and personal-social skills. The questionnaire takes about 10 to 20 minutes to complete. Please bring your completed survey with you to your visit with your child's pediatrician.

Index of Questionnaires >>

Edades y Etapas Cuestionario (ASQ) y hojas edad-apropiadas de actividades >>

Registration Forms

Form for new patients.

PDFRegistration Form

PDFEl Formulario de Registro (Spanish)

Questions to Ask Your Insurance About Coverage

This worksheet will help you determine whether immunizations are a covered benefit under your policy and what portion you may be responsible for.

PDFImmunization Benefit Form


Is Your Child Sick?