Visits

Labs/Other

Vaccinations

Questionnaire

Newborn

 --- --- Newborn questionnaire

1- 4 weeks

 --- ---
Infant questionnaire

2 months

 ---  DTaP / IPV / HBV (combined)
HIB
PCV13
Rotavirus

2-4 month questionnaire

4 months

 ---  DTaP / IPV / HBV (combined)
HIB
PCV13
Rotavirus

2-4 month questionnaire

6 months

 ---  DTaP / IPV / HBV (combined)
PCV13
Rotavirus
Influenza*

6 month questionnaire

9 months

 ---  Influenza* 9 month questionnaire

12 months

Hemoglobin
Lead test*
Tuberculosis test*
Fluoride dental varnish*

MMR
Varivax
HAV
Influenza*

12 month questionnaire

15 months

--- HIB
PCV13
Influenza*

15-18 month questionnaire

18 months

Fluoride dental varnish* DTaP
HAV
Influenza*

15-18 month questionnaire & M-CHAT

2 years

Lead test*
Fluoride dental varnish*

HAV
Influenza*

2 year questionnaire & M-CHAT

3 years

Vision test
Hearing test
Fluoride dental varnish*

Influenza*

3-4 year questionnaire & Practice sheet for vision test

4 years

Vision test
Hearing test
Fluoride dental varnish*
MMR / Varivax (combined)
DTaP / IPV (combined)
Influenza*

3-4 year questionnaire

5 years

Vision test
Hearing test
Tuberculosis test*
Fluoride dental varnish*

Influenza*

5 year questionnaire

6 & 7 years

Hearing test*
Vision test
Fluoride dental varnish

Influenza*

6-10 year questionnaire

8, 9, & 10 years

Vision test
Hearing test*

Influenza*

6-10 year questionnaire

11 years

Hearing test
Vision test
Lipid test
Tuberculosis test*

MCV4
TDaP
HPV
Influenza*

Pre-teen questionnaire
Patient | Parent
12 years Vision test
Hearing test*
Hemoglobin*
Urinalysis*

HPV
Influenza*

Pre-teen questionnaire
Patient | Parent

13 & 14 years

Vision test
Hearing test*
Hemoglobin*
Urinalysis*

HPV
Influenza*

13 & 14 year questionnaire
Patient | Parent

15 & 16 years

Vision test
Hearing test*
Hemoglobin*
Urinalysis*

HPV
MCV4 (16 yrs)
Influenza*

15-17 year questionnaire
Patient | Parent

Handouts

17 years

Vision test
Hearing test*
Hemoglobin*
Urinalysis*

HPV
Influenza*

15-17 year questionnaire
Patient | Parent

Handouts

18 years

Lipid test
Vision test

Hearing test*

DTaP
Influenza*

Young adult questionnaire

Handouts

Young adult

Vision test
Hearing test*
PAP test (females 21+)

Influenza*

Young adult questionnaire

Handouts


*indicates vaccines or tests given as needed