ALL OF THE PHYSICIANS IN OUR PRACTICE TAKE NEWBORNS......
THE FOLLOWING PHYSICIANS ARE TAKING NEW FAMILIES TRANSFERRING INTO OUR PRACTICE:
- DR. THOMAS DU BOIS
- DR. MOLLY RUSIN
Waukesha Pediatric Associates welcomes new patients. Choosing the right pediatrician for your child is one of the most important decisions you will make. By selecting Waukesha Pediatric Associates, you can feel confident and comfortable that you have made the right decision.
To understand what to expect for your child's first visit to our practice, please read through this page.
Our practice is working together to build life-long relationships between our staff and our patients by consistently providing our patients with compassion, excellence and value. To fulfill this mission, we are committed to:
- Improving the lives of the children we serve by providing quality care in a child-centered environment.
- Listening to our young patients and their families who we are privileged to serve.
- Guiding our patients along a path of optimal health and wellness.
- Continually pursuing excellence at all levels through continuing education.
What to bring to your first visit?
We work hard to ensure that your child receives prompt medical care in a comfortable, child-friendly office setting. To help expedite the first appointment, we ask that you please bring your child's immunization records and be prepared to complete paperwork regarding your family medical history, your child's medical history, and insurance information.
We are also happy to offer you the option to download, print and complete our office forms to reduce wait times during your first appointment.
- Abdominal Pain Questionnaire
- Authorization to RELEASE Medical Information
- Authorization to RECEIVE Medical Information
- Asthma (ACT) Screening 4-11 years [English]
- Asthma (ACT) Screening 4-11 years [Spanish]
- Asthma (ACT) Screening Over 12 years [English]
- Asthma (ACT) Screening Over 12 years [Spanish]
- Child Health Report
- Edinburgh Postnatal Depression Scale
- Fluoride & Lead Screening
- FluShot Questionnaire [English]
- FluShot Questionnaire [Spanish]
- Headache History Form
- Health Questionnaire - Sports - 11 years and older
- M-CHAT Assessment Scale
- PHQ-9 Depression Screening
- SCARED - Anxiety Assessment Scale [CHILD]
- SCARED - Anxiety Assessment Scale [PARENT]
- TELEHEALTH - Consent Form
- TELEHEALTH - Information
- Vanderbilt Assessment Follow-up [PARENT]
- Vanderbilt Assessment Scale [PARENT]
- Vanderbilt Assessment Follow-up [TEACHER]
- Vanderbilt Assessment Scale [TEACHER]
- WIAA Athletic Permit Card
In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it.
What to Expect
On the day of your child's first visit to our office, we recommend arriving a few minutes early. This allows extra time for finishing up any registration forms and ensures you have plenty of time to get acquainted with our staff and office. We look forward to meeting you and joining with you to help your child maintain optimal health.