Prepare for your appointment.
Prairie Pediatrics takes pride in providing top quality service to our patients, and part of that service is giving you the ability to complete as much of our office paperwork on your own time and in the convenience of your own home. The more you can complete ahead of time, the more efficient, fun, and informative our office visit will be. We look forward to seeing you!
Here's what you need to do:
- Download all of the applicable forms below, choosing the appropriate Health Questionnaire for your child's age.
- Please fill out all forms clearly and completely, with black ink.
- Make sure to include your Social Security Number as needed.
- Please sign and date forms where indicated.
All documents below are PDF files. All you need to do is click, download, and print--and remember to bring them with you when you visit our office
New Patient Forms – 2 months of age and younger
New Patient Forms – Over 2 months of age
Established Patient – Yearly Forms
ADHD Forms - Dr. Ray Sturdevant/Sue Sorenson, ARNP
Paciente Nuevo – 2 meses o menor
Paciente Nuevo – 2 meses o mayor
Paciente Establecido – for Formulario Anual
Formulario para ADHD – Dr. Ray Sturdevant/Sue Sorenson, ARNP