Welcome to WellnessOne,
We strive to make your experience as smooth and efficient as possible so here is what you can expect in your visit.
Please complete this personal health history questionnaire form for your child.
You will have a one-on-one consultation with the doctor to discuss the health concerns that you have for your child.8
A comprehensive examination and evaluation including those tests necessary to determine the precise cause of the problem is given. The doctor will advise you if additional laboratory tests or x-rays are needed.
REPORT OF FINDINGS
If we feel we can help your child we will tell you. This will include a thorough explanation of how our treatment works and what results we feel can be obtained. If we feel we cannot be of help to your child we will provide you with a recommendation and/or referral to another provider that we feel will be of most benefit.
Please complete the following pages to save time and help us to serve you better. Thank you.
Name of Pediatrician
Date of Last Visit
At what age, in months, was the following introduced?
At what age was your child able to (in months):
Personal Illness History