Adolescent Well Visit Forms

Have your child complete the appropriate form(s):  If you are completing online, use a computer (not cell phone).  You can email to:   or fax to: 770-988-5553.  Or, you can print and bring with you.

Adolescent Health Questionnaire for 11-12 years old  Print and give to your child to complete before the appointment.

Adolescent Health Questionnaire for 13 years and older Print and give to your child to complete before the appointment.

Pediatric Cardiac Risk Assessment for 11 yo and 14 yo For parent to complete either online or print.

Tuberculosis/Lead Risk Assessment For parent to complete either online or print. (for Amerigroup, CareSource, PeachState and Medicaid patients only)

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