Well Child Check-up Request Form

NOTE: This form is reserved for Well Child Check-up requests only. If you need a same-day sick appointment, please call your office directly.

This Well Child Check-up Request form is for existing Blue Fish patients. If your child is not yet a patient, please fill out our New Patient Application.

Please confirm with your child’s health insurance plan if annual well visits are covered under calendar year or plan/contract year.

Once you have submitted your request, we will call you within 2 business days to schedule your child’s appointment.