Parents Page

Downloadable Forms

Please download, review, and complete (if necessary) the forms available below.

Download Patient Information Form

Download Release of Information Form

Download Initial History Questionnaire

Download Vaccine Policy


No-Show Policies

Please review our new policies related to no-show appointments.

Current Patient No-Show Policy

New Patient No-Show Policy

UPCOMING FLU CLINICS ANNOUNCED!

Flu clinics are on a walk in basis from 3 p.m. - 6 p.m.   Sorry parents, these are only for the kiddos, but we highly recommend you talk to your Dr. or Pharmacist about getting vaccinated yourself which also protects your kids!  If you have any questions please do not hesitate to call one of our two locations and ask one of our knowledgeable staff!   

9/20/17-Beaver Dam location

10/3/17-Waupun location

10/17/17-Beaver Dam location

10/25/17-Waupun location

11/9/17-Waupun location

11/15/17-Beaver Dam location

HELPFUL LINKS . . .

AAP Pediatric Patient Education

Pediatric patient education materials 

American Academy of Pediatrics 

Dedicated to the health and well-being of infants, children, adolescents and young adults.

Family Voices 

A statewide network of families who have children and youth with special health care needs and/or disabilities.

FACETS 

A 501(c)(3) non-profit organization providing comprehensive programs and services that enhance the quality of life for children and adults with disabilities and their families.

CHADD 

A 501(c)(3) non-profit organization providing education, advocacy and support for individuals with ADHD.

Children's Health Alliance of Wisconsin 

A Wisconsin based organization that raises awareness on important issues related to children's health. They work with leaders to create policy, and impact public health by implementing programs that are proven to work.

Reach Out and Read 

A nonprofit organization that gives young children a foundation for success by incorporating books into pediatric care and encouraging families to read aloud together.