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Adolescent Forms

If your teenager or pre-teen has a well check-up in our office, we may ask that you complete one or more of these questionaires.

There are many questions on these forms. Some of the questions may be embarrassing for your adolescent. In some cases your pre-teen may not understand the question. Please tell your child it is OK not to answer any questions they feel uncomfortable with or do not understand.

It can help to make your visit proceed faster if you print and complete the form at home. Then bring the completed form to the office visit for your doctor to review.

To see the form, click on the appropriate form and language below. 

Parent Questionnaire

Pre-Teen Questionnaire

Teen Questionnaire