COVID-19: See the latest assessment and care options, plus temporary visitor restrictions.

Pre-Visit Forms for Well Child Exams and Physicals

For your convenience, Charlotte Pediatric Clinic will send your age specific pre-visit paperwork via email prior to your well child exam/physical. Once you receive the email please click the link to complete all required forms prior to your visit.

You can easily complete these from any smartphone, computer or tablet. Completing this paperwork helps your provider assess the growth and development of your child, allowing you to fully engage with your care team. Please complete at least 48 hours prior to your visit. 

General Patient Information

ADHD Forms

NICHQ Vanderbilt Assessment Scale

SouthPark
Phone: 704-367-7400
Fax: 704-367-7555

Blakeney
Phone: 704-512-5060
Fax: 704-564-4868

Matthews
Phone: 704-512-6820
Fax: 704-512-6821

Steele Creek
Phone: 704-512-6100
Fax: 704-587-7601

Hours of Operation
Monday - Friday, 8 a.m. - 5 p.m.

Weekend Sick Clinic
Established patients can reserve appointments at our SouthPark Sick Clinic, Saturdays and Sundays, 8 to 11:55 a.m. Reserve your spot online before leaving home.

Close