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Visitor Guideline Update: Due to respiratory virus season, children 12 and under are not permitted to visit patients in multiple settings. Additionally, everyone is required to mask in patient rooms and other designated areas. Learn more.

From infants and toddlers to children and teens, every child deserves excellent, comprehensive care. To help us deliver the best care, we need to learn a little about your child before they visit an Atrium Health Levine Children's primary care office.

By completing these forms ahead of time, you can keep your focus on your child throughout their visit.

Pre-Visit Forms for well child exams and physicals

Before visiting your Levine Children’s provider, you’ll need to complete paperwork. This paperwork includes:

  • New patient information
  • Well-child check forms
  • Vaccination policies for children
  • Insurance and billing information
  • Medical records requests

Send forms electronically

For your convenience, your child’s doctor will email age-specific paperwork before their well visit or physical.

Once you get the email, please click the link, and complete all required forms at least 5 days before your child’s visit. You can easily complete these forms from any smartphone, computer or tablet. 

Download and print forms

If you did not receive or are unable to complete the electronic forms, you can download the following pre-visit forms and bring them to your appointment.

Childhood vaccination schedule

Vaccines protect your child from serious diseases, and it’s important to follow the recommended schedule for immunizations.

View the schedule to know which vaccines your child might need at their next visit.

Contact us

If you need help or have questions, please call your Levine Children’s provider.