Doctors' Pediatirc Well Visit Schedule Template
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1
2DOCTORS’ PEDIATIRC WELL VISIT SCHEDULE
Well Child Visit
Nurse Procedures & Handouts
Tests
Recommended Vaccinations
Prenatal
Welcome kit
N/A
N/A
New baby
New baby handout given
Hepatitis B if not given in hospital
Head circumference (HC)
Weight
Length
2 weeks
HC
Postnatal Screen
None
Weight
Length
6 weeks
6-8 week handout
Hep B # 2 (Hepatitis B)
(must be on or
Vaccine Info Sheets
IPV # 1 (Polio Vaccine)
after 6 weeks
HC
Rota # 1 (Rotavirus Vaccine)
of age)
Weight
Length
9 weeks
3-4 month handout
Postnatal Screen
DTaP #1 (Diphtheria, Tetanus, Pertussis)
Vaccine Info Sheets
Hib #1 (Haemophilus Influenza)
HC
Prevnar #1 (Pneumococcal)
Weight
Length
4 months
Solid food handout
DTaP #2
Rota #2
Hib #2
Vaccine Info Sheets
IPV #2
Prevnar #2
HC
Weight
Length
6 months
5-6 month handout
DTap #3
Hib #3
Prevnar #3
Vaccine Info Sheets
Rota #3
Influenza (if
Choking pamphlet
desired)
HC
Weight
Length
9 months
8-9 month handout
Hemoglobin
Hep B # 3
Vaccine Info Sheets
Lead
Poison control sticker
HC
Weight
Length
12 months
1 year handout
Prevnar # 4
Hib #4
st
(must be on or
Vaccine Info Sheets
Hep A #1 (on or after 1
bday)
st
after 1
bday)
HC
MMR #1 (Measles, Mumps, Rubella)
Weight
Length
15 months
Vaccine Info Sheets
M-Chat
HC
Varivax #1 (Varicella Vaccine)
Weight
Hep A #1 (if not given)
Length
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