Welcome to the Developmental Pediatrics Clinic

The goal of your child’s visit is to receive a thorough evaluation and to have your questions answered. For this reason, it is essential that you complete and return the enclosed paperwork at least two weeks before your child’s appointment.

Here is a helpful hand out on what you can expect at your initial visit.

For parents

(Educators or care providers: please see “For educators or care providers” section below.)

Forms to complete

The following forms will need to be completed prior to your visit and sent in:

• Parent/Guardian Questionnaire
• Authorization to Release/Request of Information forms

How to send in completed forms

After you have completed the Parent/Guardian Questionnaire and the Authorization for Release/Request of Information forms we ask that you send them to us either via mail, fax, or e-mail through My Children’s Portal. Regardless of the method you choose, you will need to be able to download and print the forms. If you cannot do so, please contact the Intake Coordinator at 651-220-6602 and request that the paperwork be mailed to you.

Mail forms to:
Children’s Minnesota
Mail Stop CSC-390 Dev Peds Clinic
2525 Chicago Avenue South
Minneapolis, MN 55404

Fax forms to:  612-813-6953

Send forms via My Children’s by:

1. Download, print and complete the Parent/guardian Questionnaire and the Authorization for Release/Request of Information forms.
2. Scan them into your computer, and save them as a document.
3. Log into My Children’s, create a message to Developmental Peds Clinician, attach your saved documents and, hit send.

Additional information

• Medications: Please bring a list of your child’s medications and doses to the appointment.
• Insurance: Please bring your insurance card with you to the appointment.  Contact your insurance company to see if a referral is needed from your primary care provider for this appointment.
• Canceling appointment: If you need to cancel or reschedule your appointment, please call three business days before your appointment.

If you have any questions about the appointment or the forms that need to be completed, please contact the clinic at 612-813-6777. We look forward to meeting you and your child.

For educators or care providers

The goal of your child’s visit is to receive a thorough evaluation and to determine how to best support each individual child. For this reason it is central to our process that we get your feedback. We ask that you complete and return the forms listed below least two weeks before your child’s appointment.

Forms to complete

The following forms will need to be completed:

• Developmental Pediatric School/Program Questionnaire (Ages 5 and under)
• Developmental Pediatric Teacher Questionnaire (Ages 6 and up)

How to send in completed forms

After you have completed the Developmental Pediatrics School/Program Questionnaire we ask that you send them to us either via mail, fax, or by returning the forms to the parent.  Regardless of the method you choose you will need to be able to download and print the forms. Please contact the parent if you are unable to download and print the forms. The parent may contact the Intake Coordinator and request that a paper packet be mailed out for completion.

Mail forms to:
Children’s Minnesota
Mail Stop CSC-390 Dev Peds Clinic
2525 Chicago Avenue South
Minneapolis, MN 55404

Fax forms to:  612-813-6953