Forms

A Child Health Form will be provided to you at every well visit for patients age 4 years and up. This form includes the child’s medications, exam, and immunization record. It can be used for school, camp, or sports participation. Please keep a copy for your records.

The State of California requires specific forms to be completed for both Day Care and School Entry. Certain schools or camps also have their own forms. Please bring these forms with you to your child’s well visit. There is a $10 charge for completion of forms not presented at the time of a visit for that child. Please allow a 7-10 day turnaround for forms brought separately from a child's visit.

State Forms

School and Camp Forms