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.

