Visit Screening

A few quick questions

Before we book the visit, we want to make sure telehealth is the right fit for what's going on today.

This is a screening form, not medical advice. If you believe your child is having a medical emergency right now, please call 911 or go to your nearest emergency department. Your answers to these questions help us route your child to the right kind of care today.
1. Your Info 2. Confirm 3. Screening 4. Result
Step 1 of 3

Tell us who this visit is for

We need a few details to attach today's screening to the right patient chart. Information you share here stays private and is only used for your child's care.

Parent or guardian

Child or children needing a visit today

Each child needs their own screening. You can add more than one child if needed.

← Cancel
Step 2 of 3

Please verify your information

Take a quick look. If anything's off, click Edit to fix it.

Step 3 of 3
Screening for
Child

Please answer each question honestly. Answer based on how your child is doing right now, not how they were earlier today.

Contact us

Tell us what's going on

We'll review what you entered against our records and get back to you within 1 business day.

Message received. Thank you.

We'll review what you sent and get back to you within 1 business day at the email address you provided.

If your situation is urgent in the meantime, you can also reach us at info@herohousepediatrics.com.

Return home

All screenings complete.

Thank you for taking the time to complete these screenings. We've received your answers and are reviewing them now.

If we need anything else from you before your scheduled visit, we'll reach out by email.

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