AGE 11-14 YEAR FORMS

Office Policy Addendum- Everyone must complete:

 

Covid Policy Addendum

11-14 Year Forms

Your child must be over the age of 11, and not yet 15  at the date of their scheduled appointment to complete these forms. 

All of these forms can be completed from your phone or computer. Please click on the link, submit the form, then come back to this page to complete the next link. There are 5 forms in total to complete. Two for the parent and three for the child.

Parents Please Complete: 

1. Bright Futures 

2. TB

Please have child complete: 

1.  Adolescent 

2.  Anxiety

3Depression

If this is your first time at our office, please complete these as well. And Welcome!

New Patient Intake

 

Office Policies 

Covid Policy Addendum

 

Health History

Fax: 618-281-8393 

PHONE HOURS: Monday-Friday 8:00-4:30,

Evening and Weekend Appointments Available

Evening and Weekend Appointments Available

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