Deceriana Uy: Periatrican Rocky Point New York
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631.509.0671
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FINANCIAL AND OFFICE POLICIES
WELL FORMS
New & Transferring Patients
Newborns
BABIES 1 MTH – 2 YRS
YOUNG CHILDREN AGES 3-9
Early Adolescent
Middle Adolescent
Late Adolescent
Immunization
Insurance
Office Forms
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Contact
649 Route 25A, Suite 3,
Rocky Point NY 11778
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631.509.0671
BABIES 1 MTH - 2 YRS
During your baby’s First Year, the following vaccines will be administered:
2 Months: Pediarix, Prevnar 13, Pedvax, Rotarix
4 Months: Pediarix, Prevnar 13, Pedvax, Rotarix
6 Months: Pediarix, Prevnar 13
9 Months: catch up of any missed vaccines
12 Months: MMR #1, Varicella #1
**Lead Levels will be checked during this visit**
Please select the button to access forms that best fits your child’s age:
2 Week — 1 Month Well
Developmental Screening
Neonatal History
Copay, Coins, Ded, Non-covered Services Consent Form
2 Month Well
Developmental Screening
Personal Social 2 Months
Copay, Coins, Ded, Non-covered Services Consent Form
4 Month Well
Developmental Screening
Personal Social 4 Months
Copay, Coins, Ded, Non-covered Services Consent Form
6 Month Well
Developmental Screening
Personal Social 6 Months
Copay, Coins, Ded, Non-covered Services Consent Form
9 Month Well
Developmental Screening
Personal Social 9 Months
Copay, Coins, Ded, Non-covered Services Consent Form
12 Month Well
Developmental Screening
Personal Social 12 Months
M-CHAT
Copay, Coins, Ded, Non-covered Services Consent Form
15 Month Well
Developmental Screening
Personal Social History
M-CHAT
Copay, Coins, Ded, Non-covered Services Consent Form
18 Month Well
Developmental Screening
Personal Social
M-CHAT
Copay, Coins, Ded, Non-covered Services Consent Form
2 Year Well
Developmental Screening
Personal Social
Lead Screening
Copay, Coins, Ded, Non-covered Services Consent Form
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631.509.0671
Home
About
Office Photos
Form Requests
FINANCIAL AND OFFICE POLICIES
WELL FORMS
New & Transferring Patients
Newborns
BABIES 1 MTH – 2 YRS
YOUNG CHILDREN AGES 3-9
Early Adolescent
Middle Adolescent
Late Adolescent
Immunization
Insurance
Office Forms
Reviews
Contact
649 Route 25A, Suite 3,
Rocky Point NY 11778
DIRECTIONS