Forms

Forms

New Patient Forms


Established Patient Forms

NEXPLANON 


Immunizations


School, Sports and Camps

To ensure that any health conditions are identified and addressed appropriately, this questionnaire must be completed before a sports physical form is signed by your doctor.

Requirements vary by school district and program. Please confirm required forms and deadlines before scheduling an appointment. Links to the various Eastside school districts can be found here.


eTravel Clinic

Allegro Pediatrics offers pre-travel health consultations that are online, affordable and convenient. The eTravel service is offered at a cost of $60. Please note that, while we will bill your insurance, you will be responsible for this amount if the service isn’t covered. Learn more here.

*The eTravel service will be unavailable from June 7th through September 8th. If you will be traveling overseas during that time, we encourage you to take advantage of this service as early as possible.*


Academic/Behavioral Concerns

These forms may be requested before an appointment for academic/behavioral concerns for school-age children. Please fax the form to the clinic where your appointment is scheduled, 48 hours before your appointment.


Developmental Screening

This form is requested as part of the Well Child Check-up for 18 and 24 months, and it may be completed prior to the appointment.