First Visit

Part A: (all ages)

A Note From Todd Burton, M.D.

Additional Charges Outside of Wellness Visit

Advanced Practice Nurse Consent to Treatment

Authorization to Treat

Financial Policy

ImmTrac2 Consent Form

Patient Information Sheet

Physician Assistant Consent for Treatment

Part B: (select by age)

Birth to Five Years

Five Years and Up

ADD/ADHD

NICHQ Vanderbilt Assessment Scale – Parent

NICHQ Vanderbilt Assessment Scale – Teacher

NICHQ Vanderbilt Assessment Followup – Parent

NICHQ Vanderbilt Assessment Followup – Teacher

Feeding

Infant Feeding Chart

Facts for Teens: Calcium and You

Food Sources for Calcium and Vitamin D

Shots/Vaccines

Chicken Pox

Diphtheria, Tetanus & Pertussis (DTaP)

Flu Consent

Polio Vaccine

Rotavirus

Pneumococcal Conjugate (PVC13)

Meningococcol

Measles, Mumps & Rubella (MMR)

Hepatitis A

Hepatitis B

Human Papillomavirus (HPV)

Haemophilus Influenzae Type b (Hib)

Age Appropriate Safety

Normal Signs of Child Development

Newborn Appearance and Behavior

Birth to 6 Months

6 to 12 Months

1 to 2 Years

2 to 4 Years

5 Years

6 Years

8 Years

10 Years

Other

Car Seat Safety Checkup

Insect Repellent Fact Sheet