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DOCTOR:  FOUR YEAR OLD VISIT
WEIGHT:
                                                          DATE:
HEIGHT:
         lbs.                oz. Blood Lead risk assessment

         ins.                          Tuberculosis risk assessment

                                                 Visual Acuity
                                                 Audiogram

INFORMATION FOR THE DOCTOR:

QUESTIONS/PROBLEMS:

NOTES:

Helpful Hints:
At this age or earlier children will be curious about where babies come from and
the differences between boys and girls. You should be prepared to answer
these questions honestly in terms your child can understand. Use the correct
terms for genitals. Sexual curiosity and explorations at this age are NORMAL.
Read Section Vi-H. When To Start Kindergarten.
Safety Tips: Please read the following sections in this booklet.

            Section Viil-0. Pedestrian Safety
            Section Viil-i. Fire Safety

Your next appointment for a physical is when your child is 5 years old.

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