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19 Year and Older Physical - Male

A TB RISK ASSESSMENT form needs to be completed.

A NUTRITION QUESTIONNAIRE needs to be completed.

A PHQ-9 QUESTIONNAIRE needs to be completed only for patients with MassHealth, BMC, or Children’s Medical Security Plan insurance. If your child has any other type of health insurance, this form will not be needed.

An ADOLESCENT QUESTIONNAIRE needs to be completed.

ADOLESCENT FORMS INFORMATION: please read

ADOLESCENT RELEASE form needs to be completed.

HEALTH CARE 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 himself.

Please click on the above links, print and complete the forms, and bring them with you to the appointment.

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

Your provider will decide if any 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.


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