
Providence Esther Short Clinic - Vancouver
Providence Esther Short Clinic - Vancouver
When you choose a primary care provider from Providence Medical Group for you or your family, you are choosing from a team of physicians and providers who are as interested in keeping you healthy as in getting you well.
To schedule a new patient appointment with a primary care provider at this clinic, call 503-582-2185.
Our services include:
- Primary care
Providence Medical Group wants to help ease the way of our patients by providing new patient medical forms and privacy notice information in advance of their first visit.
Please review all of the information below and complete the necessary forms prior to any patient's first appointment to allow for quick and easy processing.
Complete this form (see below):
Review this information:
-
Well Child Checklist
A list of developmental questionnaires from birth to age 21.
- Developmental Questionnaire: 0-7 Days
- Developmental Questionnaire: 2 Weeks-1 Month
- Developmental Questionnaire: 2 Months
- Developmental Questionnaire: 4 Months
- Developmental Questionnaire: 6 Months
- Developmental Questionnaire: 9 Months
- Developmental Questionnaire: 12 Months
- M-CHAT-R (Modified Checklist for Autism in Toddlers Revised)
- Developmental Questionnaire: 15 Months
- Developmental Questionnaire: 18 Months
- Developmental Questionnaire: 2 Years
- Developmental Questionnaire: 2.5 Years
- Developmental Questionnaire: 3 Years
- Developmental Questionnaire: 4 Years
- Developmental Questionnaire: 5 Years
- Developmental Questionnaire: 6 Years
- Developmental Questionnaire: 7-8 Years
- Developmental Questionnaire: 9-10 Years
- Confidential Teen Pre-Visit Questionnaire
- Developmental Questionnaire: 11-12 Years
- Developmental Questionnaire:13-14 Years
- Developmental Questionnaire: 15-17 Years
- Developmental Questionnaire: 18-21 Years
-
Well Child Checklist (Spanish)
Una lista de los cuestionarios de desarrollo desde el nacimiento hasta los 21 años.
- Cuestionario pre-consulta: De recién nacido a 0-7 días
- Cuestionario pre-consulta: 2 semanas a 1 mes de edad
- Cuestionario pre-consulta: 2 meses de edad
- Cuestionario pre-consulta: 4 meses de edad
- Cuestionario pre-consulta: 6 meses de edad
- Cuestionario pre-consulta: 9 meses de edad
- Cuestionario pre-consulta: 12 meses de edad
- Cuestionario pre-consulta: 15 meses de edad
- Cuestionario pre-consulta: 18 meses de edad
- Cuestionario pre-consulta: 2 años de edad
- Cuestionario pre-consulta: 2.5 años de edad
- Cuestionario pre-consulta: 3 años de edad
- Cuestionario pre-consulta: 4 años de edad
- Cuestionario pre-consulta: 5 años de edad
- Cuestionario pre-consulta: 6 años de edad
- Cuestionario pre-consulta: 7-8 años de edad
- Cuestionario pre-consulta: 9-10 años de edad
- Cuestionario de la salud del adolescente
- Cuestionario pre-consulta: 11-12 años de edad
- Cuestionario pre-consulta: 13-14 años de edad
- Cuestionario pre-consulta: 15-17 años de edad
- Cuestionario pre-consulta: 18-21 años de edad