Before Your Well Care Visit

If your child is 0 to 7 days old, open the following two documents:

Birth to 1 Week – Well Check Health Questionnaire [English/Spanish]: (Please print, fill out and bring to the well care visit)

Birth to 1 Week – Checkup Information Sheet: (Read and write down any questions you have)

If your child is 2 to 6 weeks old, open the following two documents:

2 to 4 Week – Well Check Health Questionnaire [English/Spanish]: (Please print, fill out and bring to the well care visit)

2 to 4 Week – Checkup Information Sheet: (Read and write down any questions you have)

If your child is 1 1/2 to 3 months old, open the following two documents:

2 Month – Well Check Health Questionnaire [English/Spanish]: (Please print, fill out and bring to the well care visit)

2 Month – Checkup Information Sheet: (Read and write down any questions you have)

If your child is 4 to 5 months old, open the following two documents:

4 Month – Well Check Health Questionnaire [English/Spanish]: (Please print, fill out and bring to the well care visit)

4 Month – Checkup Information Sheet: (Read and write down any questions you have)

If your child is 6 to 8 months old, open the following two documents:

6 Month – Well Check Health Questionnaire [English/Spanish]: (Please print, fill out and bring to the well care visit)

6 Month – Checkup Information Sheet: (Read and write down any questions you have)

If your child is 9 to 11 months old, open the following two documents:

9 to 10 Month – Well Check Health Questionnaire [English/Spanish]: (Please print, fill out and bring to the well care visit)

9 to 10 Month – Checkup Information Sheet: (Read and write down any questions you have)

If your child is 12 to 13 months old, open the following two documents:

12 Month – Well Check Health Questionnaire [English/Spanish]: (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 the following two documents:

14 to 15 Month – Well Check Health Questionnaire [English/Spanish]: (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 the following two documents:

18 Month – Well Check Health Questionnaire [English/Spanish]: (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 the following two documents:

21 to 24 Month – Well Check Health Questionnaire [English/Spanish]: (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 to 3 years old, open the following two documents:

3 Year – Well Check Health Questionnaire [English/Spanish]: (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 the following two documents:

4 to 5 Year – Well Check Health Questionnaire [English/Spanish]: (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 to 6 years old, open the following two documents:

5 to 6 Year – Well Check Health Questionnaire [English/Spanish]: (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 5 to 6 years old, open the following two documents:

5 to 6 Year – Well Check Health Questionnaire [English/Spanish]: (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 to 8 years old, open the following two documents:

6 to 8 Year – Well Check Health Questionnaire [English/Spanish]: (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 to 10 years old, open the following two documents:

8 to 10 Year – Well Check Health Questionnaire [English/Spanish]: (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 to 12 years old, open the following two documents:

10 to 12 Year – Well Check Health Questionnaire [English/Spanish]: (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)

Sports Checkup Information

Athletic Screening Exam

Better Sports Performance

Information for Parents of Teens

Parent Questionnaire [English/Chinese]: (Please print, fill out and bring to the teen well care visit)