Surveys and Questionnaires
Please download, print and complete the specific survey recommended at your child’s appointment. Once complete, please portal message them back, or drop them off to clinic, then set up a follow up appointment to go through them with your child’s primary care pediatrician.
Vanderbilt Scale
SCARED Questionnaire
GLAD-PC Survey
SCOFF Questionnaire
Trauma Scale
Patient Forms
The following PFD forms may be useful to you prior to your visits with us.
AIA Preparticipation Physical Evaluation
M-CHAT Developmental Questionnaire (for 18 mo and 30 mo visit)
Patient Consent for Use and Disclosure of Health Information
Authorization for Release of Medical Records
Child Development Handouts
Our well-child handouts are available in PDF format below. Please feel free to print them out if you have questions about age-related development. They are also viewable online. These handouts are available on your portal account prior to each appointment.
Covid-19 Vaccine for 5 & Up!
FAQs
Any Tanque Verde Pediatrics Patient aged 5 and Up.
Is it recommended that my child, aged 5 & up, get the Pfizer Covid-19 vaccine?
YES. We are recommending the vaccine for all of our patients in this age group.
Are you giving this vaccine to parents as well?
Yes! If you call us and register in advance, we can do your booster shot as well!
Can my child with asthma get the vaccine?
YES! There is no contraindication to the vaccine other than allergy to any of its components. We recommend that any child with any immune suppression or dysfunction, any chronic illness (respiratory or otherwise) or any child age 5 & up get this vaccine.
Can my child who has already had Covid-19 disease get vaccinated?
Yes and it is recommended that they do. As long as they are asymptomatic on the day of vaccine and out at least 10 days from diagnosis, they can move forward with vaccination.
Can my child who is currently in quarantine after a Covid-19 exposure be vaccinated?
No. It is recommended that your child complete their quarantine. Then they can get the vaccine.
If my child has a fever or is sick on the day of vaccination, can they get the vaccine?
No. Please do not send any sick children in for a vaccine. They will be turned away for a medical assessment.
Can I preview the allergy list and questionnaire to make sure my child is eligible?
YES! Click Here
How do I sign my child up?
- Call our office to set up an appointment 520-722-2585.
- Then, if you have not filled out a consent form, please do so by clicking this link. If your child had your first Pfizer Covid vaccine in our office on 5/22 or 5/23, you already have a consent on file, so you don't have to fill out another one.
Can my child who drives come by themselves?
Yes. The form has a consent form within it, so if you are comfortable sending your child in by themselves, we will monitor them for 15 minutes as recommended prior to letting them go.
My child got their first vaccine at another site. Can they get their second vaccine at TVP?
Yes! Make sure that it is at least 21 days after his/her/their first shot. Just fill out the consent form, and call our office to schedule that appointment. Don't forget to bring your child's vaccination card with you!
To Sign Up:
- Fill out the consent form if you don't already have one on file with our office.
- Call our office (520-722-2585) to make your appointment
Office Resources
Policies and Forms
Telemedicine FAQs
Vaccine Policy
Email Newsletters
Health Resources
Symptom Checker
Immunizations
Dosing Guide
Handouts and Surveys
Books and Websites