Planning Your Visit | Southwest Pediatrics, LTD.

Planning Your Visit

Telemedicine

HOW TO CONNECT TO TELEVISIT

HOW TO CONNECT VIA PATIENT PORTAL

For all new patients

NEW PATIENT FORM

FAMILY HISTORY QUESTIONNAIRE

HIPAA RELEASE FORM

Newborn

NEW PATIENT FORM

NEWBORN CHECKLIST

FAMILY HISTORY QUESTIONNAIRE

1 Month

POSTPARTUM DEPRESSION FORM

9 months

LEAD SCREEN FORM

18 months

LEAD SCREEN FORM

24 month

LEAD SCREEN FORM

5 year

LEAD SCREEN FORM

6-10 year

SCHOOL MEDICATION FORM

SCHOOL ALLERGY FORM

11-12 year

SCHOOL SPORTS CLEARANCE FORM

SCHOOL MEDICATION FORM

SCHOOL ALLERGY FORM

13-14

SCHOOL SPORTS CLEARANCE FORM

SCHOOL MEDICATION FORM

SCHOOL ALLERGY FORM

15-17

SCHOOL SPORTS CLEARANCE FORM

SCHOOL MEDICATION FORM

18+

INFORMATION RELEASE CONSENT FORM

HEALTHCARE TRANSITION FORM

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