12 MONTH FORMS

12 Month Forms

Your child must be 12 months or older at the date of their scheduled appointment to need 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 3 forms in total to complete. 

Bright Futures

Lead

TB

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

  • White Facebook Icon
  • Instagram - White Circle