Prior to your appointment, please fill out the forms below for every follow-up visit. This will save time and provide a contactless check-in process.
To complete pre-visit forms before your next appointment with us, simply click on the form you’d like to fill out, fill in the responses for your child (please complete all checkboxes and spaces for written answers), and a “sign” button will appear when the form is completed. Hit “sign” and you’re done!
No “sign” button? Check to make sure that you’ve filled in commonly missed information like name, date of birth, and signature. The button will only appear when all required spaces have been completed.
Pre-Visit Questionnaire Form
Asthma Control Test
Child Asthma Control Test*
*CACT (To be filled out by all asthma patients 4-11 years of age)
Asthma Control Test*
*ACT (To be filled out by all asthma patients over 12 years of age)
Cystic Fibrosis (CF) Patient
Primary Ciliary Dyskinesia (PCD) Patient