Please complete the parent portion and bring a copy to your visit for completion. These can be filled out at your child's well child visit or a sports physical visit. Sports Physical visits are $25.00 and must be paid upfront.
If you have a current well child visit (less than 6 months), we can email the form back to you.
To schedule a Well Child Visit online --> www.cardinalpediatrics.com/schedule
Securely Sign/Send Online Links | Download Fillable Forms |
WV Sports Physical Form | WV Sports Physical Form |
Most insurances allow one well child check per year for ages 3 and older, however, there are some exceptions:
- PEIA's calendar year runs from July 1 to June 30th
- Some Aetna plans only allow 1 visits every 365 days
Always check with your insurance benefit plan to see what they will cover!