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Valley Childrens Clinic

Valley Childrens Clinic

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Patient Information Forms

Click a button to view, download and/or print the form.

For the safety of our patients and staff, no more than 4 people (patient/family/guest) allowed in the room at the same time.

Para la seguridad de nuestros pacientes y el personal, no se permiten más de 4 personas (paciente / familia / huésped) en la sala al mismo tiempo.

Thank you.

Sports Physical Form
Medical Release Form
Authorization for Treatment Form
Divorce Parent Policy
VCC Patient Information Intake Form 4-2018
What you need to know about ADHD
Edinburgh Postnatal Depression Scale (English)
Edinburgh Postnatal Depression scale (Español)
Lead Risk Questionnaire
Lead Risk Questionnaire Spanish
Ages and Stages Questionnaire (ASQ)
Patient Health Questionnaire (PHQ-9)
M-CHAT (English) 18mon-24mon ONLY
M-CHAT (Español) 18mon-24mon ONLY
M-CHAT-R
Vanderbilt Parent
Vanderbilt Parent Follow-up
Vanderbilt Teacher
Vanderbilt Teacher Follow-up
Tuberculosis Elimination
Essential Oil Handout
New Patient Handout
Patient Handout Notice of Privacy Practices
CDC Vaccine Information Statements

Contact Us

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  • Phone: (956) 423-1283
  • Fax: (956) 412-3033
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Emergency 24 Hours

Call 911

Location

Hours of Operation

  • Monday – Tuesday:
    8:00am – 6:00pm

  • Wednesday – Friday:
    8:00am – 6:00pm
    Closed for lunch: 12:00 – 1:00pm
  • Saturday and Sunday:
    Closed

Attention:

For the safety of our patients and staff, no more than 4 people (patient/family/guest) allowed in the room at the same time.

Para la seguridad de nuestros pacientes y el personal, no se permiten más de 4 personas (paciente / familia / huésped) en la sala al mismo tiempo.

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