If you would like to complete your child’s medical history prior to their appointment you can download the form for their age bracket below. Please complete the form and bring it with you to the appointment.
Medical History Infant & Toddler (Age 1-2)
Medical History Child (Age 3-11)
Medical History Adolescent (Age 12-18)
If your child is under the care of a specialist for any medical, behavioral or emotional condition please complete the following form:
220 Cumberland Parkway, Suite 6
Mechanicsburg, PA 17055
Phone: 717-697-KIDS (5437)
Fax: 717-795-KIDZ (5439)
Hours:
Mon, Wed, & Fri – 7am – 4pm
Tue & Thu – 10am – 7pm
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