Forms | Pediatric Health Care Alliance P.A.

Physicals

Adolescent Questionnaire - Parent Consent

This form provides parent consent for the adolescent questionnaire that is discussed at well visits for ages 12 years and older.

Adolescent Questionnaire for PATIENTS (ages 12yrs and older)

This form is completed with parent consent at adolescent well visits for ages 12 years and older.

Sports Preparticipation Evaluation

Updated March 2023

Please Note: Portions of the new 2023 form need to be completed by the parent and student before it can be provided to your pediatrician. Click here to learn more.

We Love Our Patients

"Amazing doctors and amazing staff. My daughter are 19 and 17 and they don't want to transition to an adult doctor."

Lisa M.

"This was my pediatric office as a child. I've taken all four of my children here, my oldest is 29 and I was just here for a yearly physical for my youngest who is 12. Always the best service, they will treat you like family!"

Lisa N.

"All of the staff are incredible and always seem to go above and beyond. They are
compassionate and understanding. They always make me feel comfortable and heard in all my
concerns and take exceptional care of my children."

2023 Patient Survey

"All of the medical staff and doctors have always been very informative and
compassionate towards my son's health."

2023 Patient Survey

"All staff members have been respectful and helpful."

2023 Patient Survey

"I love this office. All staff are very nice and professional. "

2023 Patient Survey

"All the doctors are very attentive and respectful. I feel like they care about my
opinion and the well-being of my child."

2023 Patient Survey

"We have been taking all three of our kids to this office since they were born and
we wouldn't have it any other way. It's incredibly special to visit doctors who know our child
and their individual needs and to have a relationship with them."

2023 Patient Survey