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Well-Child Visit Worksheet

Information to record from your visit:

Height __________ Weight __________ Head Circumference __________

Vaccines given at this visit (circle the ones your child received):

DTaP | Hib IPV | HepBv | Prevnar | Rotavirus | Flu | Chickenpox Vaccine | MMR

Don't forget to ask about:

A Vitamin D supplement for breastfeeding babies (two months)

Using an insect repellent (two months)

Using sunscreen (six months)

A fluoride supplement (six months)

When to start solid foods (four to six months)

Lead poisoning risk factors (six to nine months)

Your child's next visit will be at __________ months.

  1. Home
  2. Father's First Year
  3. Worksheets for Pediatrician Visits
  4. Well-Child Visit Worksheet
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