Well Child Check-ups
|
| Check-up Schedule* | Paperwork | Vaccines/Tests Due |
| Newborn visit 3-5 days of age |
Patient Information Form & Patient History Form. |
|
| 2 week visit within 3 days |
Patient Information Form & Patient History Form (if not completed at Newborn visit) |
|
| 2 month visit within 1 week |
2 month check-up form |
DTaP #1, IPV #1, Comvax #1, Prevnar #1, Rotavirus #1 |
| 4 month visit within 2 weeks |
4 month check-up form |
DTaP #2, IPV #2, Comvax #2, Prevnar #2, Rotavirus #2 |
| 6 month visit within 3 weeks |
6 month check-up form |
DTap #3, Prevnar #3, Rotavirus #3 |
| 9 month visit within 3 weeks |
9 month check-up form |
CBC** |
| 12 month visit MUST be after 1 year birthday |
12 month check-up form |
Comvax #3, Chickenpox #1 |
| 15 month visit within 3 weeks |
15 month check-up form |
Prevnar #4, MMR #1, Hepatitus A #1 |
| 18 month visit within 3 weeks |
18 month check-up form |
DTaP #4, IPV #3 |
| 2 year visit within 2 months |
2 year check-up form |
Hepatitis A #2 |
| 3 year visit within 2 months |
3 year check-up form |
|
| 4 year visit MUST be after 4 year birthday |
4 year check-up form |
DTaP #5, IPV #4, MMR #2, Chickenpox #2 H & V |
| 5 year visit |
5 year check-up form |
H & V, UA** |
| 6 year visit (7 year visit #) |
6-12 year check-up form |
|
|
8 year visit (9 year visit #) |
6-12 year check-up form | CBC** at 8 yrs |
| 10 years old | 6-12 year check-up form |
H & V |
| 11 years old | 6-12 year check-up form |
Tdap, Meningococcal, HPV series (for girls only) |
| 12 - 21 years old | 6-12 year check-up form |
No vaccines needed if immunizations current |
| Annually through adolescence | adolescent check-up form |
H & V @ 15 & 18 yrs CBC **@ 13 yrs & menstruating females UA **@ 15 yrs |
* time specified can either be before or after date of the specified age.
# must have had a physical the previous year and no chronic conditions or medications
Please see www.brightfutures.org to learn more about what is involved with each check-up.
** This information used with permission from the Center of Excellence for Medial Multimedia, Office of the Air Force Surgeon General, and is available at www.vmedcenter.org

Northside Pediatrics and Adolescent Medicine
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