Behavior Issues
Any issues with peer interaction?
Does your child get adequate sleep?
Does your child have a balanced diet?
(For females only) Any menstrual problems?
Any concern about drug use?
Medications? (Please indicate date started )

275 SE Cabot Dr., Suite B-102 

Oak Harbor, WA 98277

360-675-5555

© 2020 Pediatric Associates of Whidbey Island  

1690 Layton Rd.

Freeland, WA 98249

360-331-1314