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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 – Thursday:
    8:00am – 6:00pm
    Lunch Breaks 12:00 – 2:00pm
  • Friday:
    8:00am – 5:00pm
    Lunch Breaks 12:00 – 2:00pm
  • 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.

Copyright © 2023 Valley Childrens Clinic - CABALALERO DESIGN - FDZ MARKETING

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Due to the new quarantine guidelines for Cameron County (COVID-19)

Valley Children's Clinic will open from Monday – Thursday: 8 am to 6 pm (closed for lunch 12:00 - 1:30pm) & Friday 8 am -12 pm until further notice. Saturday & Sunday: Closed. To decrease the spread of disease, please do the following: IF YOU ARE ALREADY REGISTERED with the Harlingen Family Night Clinic, return to your vehicle and call 956-423-0085. We will update your registration over the phone and if we need to collect a payment or signature for the account, we will collect it when you are called into the clinic for triage. Please note: the front desk staff will keep the widow closed or only use a small open space while completing registration. ** If you have had an insurance change, you will need to provide us with an updated card** IF YOU ARE A NEW PATIENT, you will need to come inside to register and we will need your insurance card and picture ID. Once registration is complete, triage will call you and discuss the current reason for your visit, you will then be instructed to enter the clinic for vitals and then escorted to a room for treatment. We thank you for your understanding and help during this difficult time.

Gov. Greg Abbott's Executive Order GA-19