Please fill out forms before your visit.   Find the appropriate form, fill them out on your computer and print them out. They can be faxed (383-3255), mailed or turned in at the time of your appointment.

The following forms are in PDF format and can be filled out on your computer. Or you can print them first and then fill them out on paper. You cannot save the forms after you have filled them out.

• Periodic 6 Month Registration Form
• Registration Form
• Parent registration for vaccines
• Parent registration form.doc (for emailing through housedoc.us
• Registration Form Metro Hockey League

Well Visit Forms - If you have NOT been in the office in the last 6 months, please ALSO fill out the Periodic 6 Month Registration Form noted above.  Four Seasons Pediatrics in compliance with Federal Law, known as the Red Flag Rules, requires this form to be filled out every 6 months.  In addition, the rules state that we identify you with a photo ID and your current insurance card at each visit to our office.  These rules were enacted to prevent identity theft and are for your protection.

The vaccine information statements can now be viewed online before your appointment.  Click Here to review online – GO GREEN AND REVIEW TO SAVE PAPER.

• First Visit Thru Two Month Visit
• Four Month Thru Six Month Visit
• Nine Month Thru Fifteen Month Visit
• Eighteen Month Thru Two and a Half Year Visit
• Three Year Visit
• Four Year Thru Five Year Visit
• Six Year Thru Eleven Year Visit
• Seven Year Thru Seventeen Year Visit
• Eighteen Years and Older Visit

Flu Vaccine Screening Forms:  Fill out these forms if you are coming in for a flu vaccine.  One form for each person vaccinated:

• H1N1 Flu Vaccine Screening Questionnaire.  The following version is a word document that can SAVED TO YOUR COMPUTER and then emailed to us through housedoc.us:  (H1N1 Flu Vaccine Screening Form).
• Seasonal Flu Vaccine Screening Questionnaire.  The following version is a word document that can be SAVED TO YOUR COMPUTER and then emailed to us through housedoc.us:  (Seasonal Flu Vaccine Screening Form.doc)

Adobe Reader is required to view these forms. Click here to download Adobe Reader for free.