Pediatric Primary Care

Forms

Encounter forms

Other encounters

Referrals and Faxing

Referral forms & related resources

Authorization for communication (DBP and school)
County Behavioral Health Services information
Dental list
FAP flyer
FAP referral (online)
FAP referral form (paper)
Referral information for families - LPCH
Referral information for families - SCVMC
SMCH Sleep Medicine Referral form
SMCH Weight Clinic Referral form
WIC referral (online)
WIC referral form (paper)
WIC Program Locations (2017)

See Developmental Services Contact Summary for additional referral forms

Fax cover sheets

Other frequently used forms

General Use

School & Child Care

Pre-Visit Questionnaires

Bright Futures handouts