Child Registration Forms

INTAKE FORM

Please complete one set of registration forms for EACH child. If your child has Medicaid, please call our office to register instead of completing the online forms.

START REGISTRATION
a mother with her newborn baby kissing the baby's forhead

Newborns

If only they could stay this tiny forever. There is nothing like holding your precious baby for the first time. Whether it’s your first child or your fourth, the newborn stage can seem like the most unpredictable. We are here to make sure you have peace of mind during those sleepless nights, and to celebrate with you as you enter each new phase.

  • breastfeeding
    /bottle feeding

  • sleep patterns

  • motor development
    /tummy time

  • vision/hearing

  • vaccines

Toddlers (Ages 1-4)

They just grow up so fast. Cherish these times. Some things are repeated for a reason. And never are they more repeated than during your child’s toddler years. These important years of your child’s life are a true blessing. And we want to be there with you along the way to ensure your child is reaching all of the important milestones that come with being a toddler.

  • Healthy Eating
    & Wellness

  • Motor Skills

  • Language &
    Speech Development

  • Social Development
    & Play

  • Dental Health

a small asain chid playing with blocks on the ground with cartoon glasses drawn on his face

School Age (Ages 5 - 12)

During these formative, school-age years, it’s important that your child builds healthy habits that will last a lifetime. It is also important that both you and your child build a healthy and lasting relationship with their Parkside Pediatrician. We want your Parkside Experience to be a fun and worthwhile.

  • School/Reading

  • Attention/Behavior

  • Technology
    /Screen Time

  • Personal Hygiene

  • Diet/Nutrition

Teens (Ages 13+)

The teenage years can be fun, dramatic, hectic, enlightening, and full of change. From the un-kid-like atmosphere of our waiting room with iPads to our pediatricians treating them at their level, Parkside strives to make the overall experience conducive to growth. We want your teenager to feel comfortable to open up with our team about any serious health or environmental concerns that they otherwise would not open up about.

  • Social Media
    /Internet

  • Mental Health &
    Emotional Well-Being

  • Body Development
    /Self Image

  • Independence &
    Decision-Making

  • Preparing
    For College

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