CHILD/TEEN REMOTE FOLLOW-UP VISIT
This form is appropriate for patients 17 years of age and younger and must be received prior to your appointment.
We request this form be submitted a minimum of one business day prior to the appointment to help give the staff an adequate amount of time to prepare.
A web form is available below which allows you to fill out & submit directly online.
Please note that you will need to enter pulse and weight. If you have a blood pressure reading from a recent doctor visit or a home BP machine please provide that information.
We must have the form prior to the appointment time. Without it, Dr. Mason cannot begin your visit. It would be considered a no show and incur a fee.