Forms and Resources
Please fill out page 1 and 2 prior to your appointment.
Missouri Return to Play after Concussion Form
Catholic school physical, Archdiocese of St. Louis
Missouri daycare form
Please give our office THREE business days to fill out this form for your child.
Immunization records for established patients can be downloaded through the patient portal.
Illinois school physical form. Please fill out and sign the top of Page 1 and bring to your doctor's appointment.
Forms
Medical Records
Release of Medical Records FROM St Teresa Pediatrics
Release of Medical Records TO St Teresa Pediatrics
Referring Providers
Referral from Specialty Providers to ABC and Nephrology Clinics
Referral from PCPs to ABC and Nephrology Clinics
Please fax completed forms to 314-500-5683 (LOVE)
ADHD Forms
ADHD Testing, INITIAL Vanderbilt Forms
ADHD Follow-up Assessment, Parent and Teacher Vanderbilt forms
Download and complete
Asthma & Allergies
Childhood Asthma Control Test
Download and complete
Asthma Action Plan
Download and complete
The Survey of Well-being of Young Children
Childhood Anxiety Screen by Parent Report (spreadsheet)
Childhood Anxiety Screen by Child Report (spreadsheet)
Ages & Stages Questionnaires (please print out results and bring to your checkup)
CDC’s Developmental Milestones
PBS For Parents – Child Development Activities
Well Child Handouts
Policies
Safety Resources
Missouri state high school activities association has very important information on staying safe while playing sports, including concussion.
Information on Missouri WIC
Missouri is a high-risk state for childhood lead poisoning. More info here.
How to fit a bike helmet
Safe Kids Worldwide website
Dangerous Baby Products to Avoid
Consumer Product Safety Commission
Nutrition
Some Favorite Links For Parents
KidsHealth website
BabyCenter website
Skin Conditions in Children
How to use nasal spray in kids
How to do a NeilMed sinus rinse