Note - please be aware any clinic form can be filled out before the appointment but all forms must be signed in clinic with all parties present OR with an official notary.


Medical Records

Consent for Treatment of Minors

Authorization to Release records from the ARUP Family Health Clinic

Authorization to Release Records to the ARUP Family Health Clinic


Physicals

4 Month Well Child Check

6 Month Well Child Check

10 Month Well Child Check

12 Month Well Child Check - 1 Year

18 Month Well Child Check

24 Month Well Child Check - 2 Years

36 Month Well Child Check - 3 Years

48 Month Well Child Check - 4 Year

60 Month Well Child Check - 5 Year

M- Chat Tool -  18 and 24 Month Well Child Check

Scout Physical

Sports Physical


Procedures

Spirometry- Patient Preparation


Emotional Care

Attention Deficit Disorder - Parent Form

Attention Deficit Disorder - Teacher Form