Screening Surveys for Patients & Parents

Primary Care
    

      1.  Parent/Guardian Survey – family history, health behavior, parent & child

            mental health, and parents’ readiness to change  

·   English survey

·   Spanish survey

      2.  Adolescent Survey – family history, health behavior, mental health, and

 readiness to change

·   English survey

·   Spanish survey

Referral Visits for Obese & Nutrition Management

1.   Nutrition Parent/Guardian Survey – family characteristics & concerns,  

       health behavior, parent & child mental health, and readiness to change

·   English/Spanish survey

2.  Parent/ Family Social History Form – household information and parent

      social history

·   English form

·   Spanish form

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