We are Partners in Pediatrics Ltd, a pediatrics-only clinics serving the Twin Cities. We encourage long term commitment between patient and provider. As your child grows and matures, we will actively involve him or her health care decisions.
We encourage long term commitments between patients and providers. As your children grow and mature, we will actively involve them in their health care decisions.
 

There will be appointments where we will ask you to fill out one or more forms prior to being seen. These forms help us get information important to your child's diagnosis or plan of treatment. We can mail these forms to you but it may be easier for you to download
them from this page. They are in PDF format. If you don't have the free Adobe Acrobat® Reader, follow the link on this page to download it.

ADHD forms
  
   
Packet of "Helpful Hints" handouts
 
Initial Evaluation for School Problems Visits

 
Adult (post high-school)
 
For Patients transferring ADHD care to PIP from another clinic or doctor
 
Elementary Students (gr. K-5)
 Elementary Teacher forms only
 
Middle/High School Students (gr. 6-12)
 Middle/High School Teacher forms only
 
Forms for ADHD follow-up appointments
  Elementary Teacher forms only
  Middle/High School Teacher forms only
 
Adult (post high-school)
 
Adolescent Visit Questionnaires
Teens: Print out and complete the appropriate form and bring with you to your visit
 
Preteen (10-13 yrs)
Comprehensive Teen Health (14-17 yrs)
Young Adult (18 yrs and older)
 
Allergy and Asthma Questionnaires
   
Allergy/asthma visit questionnaire
Allergy evaluation and testing consent
 
 
Medical Records Forms
 
fff
To have records sent to PIP, or from PIP to another clinic
For patients 18 years of age or older or emancipated minor
 
This form will be kept in child's chart, and includes a place to designate others who may occasionally bring a child in for medical care, such as a daycare provider, grandparent, or others the parent/guardian designates.
 
For use when a parent or guardian plans to be out of town and child(ren) will be in the care of someone else during that time.
 
A worksheet and form which lets family and medical professionals know your wishes about health care if you are unable to communicate them yourself.
 
 
New Patient Questionnaires
 
 
 
Well Child Visit Questionnaires
Click here to go to PIP's Well Child Exam and Immunization page. You will be able to open, print out, and complete questionnaires to bring along to your child's visit.
 
   
     
Partners in Pediatrics ©2008