19 Year and Older Physical – Female

TB RISK ASSESSMENT form needs to be completed.

A NUTRITION QUESTIONNAIRE needs to be completed.

A PHQ-9 QUESTIONNAIRE needs to be completed.

An adolescent-health-questionnaire needs to be completed.

ADOLESCENT FORMS INFORMATION: please read

ADOLESCENT RELEASE form needs to be completed.

mass-state-proxy form needs to be completed.

Please click on the above links, print and complete the forms, and bring them with you to the appointment. A parent can complete the TB risk questionnaire. Preferably, your child should complete all the other questionnaires herself.

 

No routine immunizations are needed at this visit. If any immunizations were missed at any previous visit, catch-up immunizations might be given today.

A blood count (CBC) will be done.

Your provider will decide if any additional labwork is needed.

Your provider will decide if a vision screen or hearing test is needed.

We will be discussing nutrition, school, and safety issues plus any other concerns that you have.