Pediatric Resources
Providing Information to Help You Care for Your Child
Sports Physicals For Kids: What to Expect
Patient Forms:
If your child is a new patient, you will be asked to complete the following packet:
New Patient Packet in English:
Initial History Questionnaire English
New Patient Packet in Spanish:
Initial History Questionnaire Spanish
Sports Physical Forms
PPE Health, physical, and medical forms
PPE – Supplement for Athletes with Disabilities
Special Olympics Medical Form Instructions
WELL CHILD VISIT FORMS:
At your child's regular check-ups, you will be asked to fill out a questionnaire about your child's health. You can complete these forms in advance by downloading the appropriate questionnaire, filling it out and bringing the completed form to your child's appointment.
Newborn Visit English and Spanish:
Two Week Visit English and Spanish:
Two Month Visit English and Spanish:
ASQ-3 (2 Month Questionnaire Spanish)
Staying Healthy Assessment Spanish
6 Month Visit English and Spanish:
Pediatric TB English and Spanish
ASQ-3 (6 Month Questionnaire-Spanish)
Staying Healthy Assessment-Spanish
9 Month Visit English and Spanish:
Pediatric TB English and Spanish
ASQ-3 (7-12 Month Questionnaire)
ASQ-3 (7-12 Month Questionnaire-Spanish)
Staying Healthy Assessment-Spanish
12 Month Visit English and Spanish:
Pediatric TB English and Spanish
ASQ-3 (12 Month Questionnaire)
ASQ-3 (12 Month Questionnaire-Spanish)
Staying Healthy Assessment-Spanish
15 Month Visit English and Spanish
Pediatric TB English and Spanish
ASQ-3 (16 Month Questionnaire)
ASQ-3 (16 Month Questionnaire-Spanish)
Staying Healthy Assessment-Spanish
18 Month Visit English and Spanish:
Pediatric TB English and Spanish
ASQ-3 (18 Month Questionnaire)
ASQ-3 (18 Month Questionnaire-Spanish)
Staying Healthy Assessment-Spanish
2 Year Visit English and Spanish:
Pediatric TB English and Spanish
ASQ-3 (24 month Questionnaire)
ASQ-3 (24 Month Questionnaire-Spanish)
Staying Healthy Assessment-Spanish
2 ½ Year Visit English and Spanish:
Pediatric TB English and Spanish
ASQ-3 (30 month Questionnaire)
ASQ-3 (30 Month Questionnaire-Spanish)
Staying Healthy Assessment-Spanish
3 Year Visit English and Spanish:
Pediatric TB English and Spanish
ASQ-3 (36 month Questionnaire)
ASQ-3 (36 Month Questionnaire-Spanish)
Staying Healthy Assessment-Spanish
4 Year Visit English and Spanish:
Pediatric TB English and Spanish
ASQ-3 (48 Month Questionnaire)
ASQ-3 (48 Month Questionnaire-Spanish)
Staying Healthy Assessment-Spanish
5 - 8 Year Visit English and Spanish:
Pediatric TB English and Spanish
Staying Healthy Assessment-Spanish
9 - 11 Year Visit English and Spanish:
Pediatric TB English and Spanish
Staying Healthy Assessment-Spanish
12-17 Year Visit English and Spanish:
Staying Healthy Assessment-Spanish
Pediatrics Resources & Downloads:
An Open Letter from Your Pediatric Providers During COVID-19 - Download
Top Tips for Kids During COVID-19 by Karisma Ebora, CPNP-PC - Download
Team Spirit During Distance Learning by Janine Arbelaez, Psy.D, LMFT -
Download
RRH Podcasts on Children's Health:
Importance of Well Visits, Vaccinations, Physicals, Summer Safety
Featuring: Jennifer Prince, DO
Recognizing Flu Symptoms in Children
Featuring: Andrew Modic, MD
Type 1 Diabetes in Children - What is it and What to Look Out For Featuring: Jesse Allande, RN
Other Downloads:
Childhood Lead Poisoning Prevention (Kern County Public Health) -
Fact Sheet (English/Spanish)
Making Healthier Choices to Help Keep Your Child Safe From Lead (Kern County Public Health) - (English)
Making Your Home Lead Safe (Kern County Public Health) - (English)
Protect Your Child From Lead (Kern County Public Health) -(English/Spanish)
Useful Links
www.safekids.org/ - Think of us as your go-to source for safety information and safety tips. On this site, you will find tips from top safety experts on everything you need to keep kids of any age safe from preventable injuries.
Available Locations
-
Rural Health Clinic
1111 N. China Lake Blvd.
Suite 201, Ridgecrest, CA 93555
(760) 499-3855