Preventative Health Care Check up exam schedule

Paperwork for schools, daycares, camps, etc.

All paperwork required by schools, daycare, camps, etc. will be filled out free of charge only at well checkup appointments.

Requests for this paperwork to be filled out at any other time will incur a fee (see fee schedule below), or you can make an appointment with a nurse practitioner to complete the form.

To have paperwork filled out other than at a check up appointment, the child must be up-to-date with well check ups (see schedule at right).

The paperwork can be brought to Patient Services at which time the fee will be paid.
The paperwork can be faxed to Patient Services at 337-478-6696 and the fee will be paid when the form is ready for pick up or payment can be provided to our Account Receivable dept. to have the form faxed back upon completion.

See Immunizations for policy regarding shot records.

Fee schedule: $5.00 charge for:
  • school medication administration forms
$10.00 charge for:
  • school/work excuses not associated with an office visit
  • 504 Dx form
  • 90L forms
  • annual summary of visits for tax returns
  • Diabetes forms
  • Headstart forms
  • Incontinent forms
  • Medical history forms for various agencies
  • Sports physicals
  • Letters
No charge for WIC 17 & 48 forms.

Well Baby Check ups:

Newborn Hospitalization: Attend delivery (if necessary); perform newborn admission history & physical examination; daily hospital visits; discharge examination & instructions.

  • 1 Week Visit: Check up; neonatal metabolic screening
  • 1 Month Visit: Check up; visit with physician or nurse practitioner
  • 2 Month Visit: Check up; Immunizations
  • 4 Month Visit: Check up; Immunizations
  • 6 Month Visit: Check up; Immunizations
  • 9 Month Visit: Check up; Hct
  • 12 Month Visit: Check up; Immunizations (Must be on or after 1st birthday)
  • 15 Month Visit: Check up; Immunizations
  • 18 Month Visit: Check up; Immunizations

Well Child Check ups:

  • 2 Year Visit: Check up
  • 3 Year Visit: Check up
  • 4 Year Visit: Check up; Immunizations (Must be on or after 4th birthday)
  • 5 Year Visit: Check up; Review for Kindergarten readiness
  • 6 Year Visit: Check up; Review for school
  • 7 Year Visit: Check up

Well Pre-adolescent and Adolescent Check-ups

  • 8 yrs to 12 yrs: Yearly check ups with Immunizations due at the 11-12 year visit.
  • 13 years to 19 years: Check up every 2 years; Cholesterol Screen; CBC and Urine dip; Catch-up Immunizations
Cholesterol Screening every 5 years, optional

See Current Immunization Schedule