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Pediatric well-child visit template
Built for routine pediatric preventive visits where growth parameters, developmental surveillance, immunizations, screening, and anticipatory guidance need a consistent home—not a sick-visit SOAP.
Template content
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Pediatric Well-Child Visit Visit Age / Context - Chronologic age and visit type (e.g., 2-month, 18-month, 5-year, adolescent well visit). - Caregiver/patient agenda and concerns for today. Interval History - Illnesses, ED/urgent care visits, hospitalizations, surgeries, and specialist care since last visit. - Medications, allergies, and chronic conditions. Nutrition / Elimination / Sleep - Feeding pattern (breast/formula/solids as age-appropriate), appetite, and growth-related feeding concerns. - Stool/urine patterns; sleep duration/quality and safe-sleep practices when relevant. Development / Behavior / School - Developmental surveillance and milestones; school performance, behavior, and social functioning as age-appropriate. - Screeners used (e.g., ASQ, M-CHAT, PHQ-A, CRAFFT) with scores if provided—do not invent scores. Social / Family / Safety - Household composition, childcare/school, tobacco exposure, food/housing security as discussed. - Safety topics: car seats, guns, drowning, screens, sun, bike helmets—as age-appropriate. Adolescent Confidential Interview (if applicable) - Mood, substances, sexual health, safety, and confidentiality limits as discussed. Growth & Exam - Weight, length/height, BMI/weight-for-length, head circumference (as applicable), and growth-chart interpretation. - Vital signs and complete/age-appropriate physical exam findings. Screenings - Vision, hearing, anemia, lead, dyslipidemia, TB risk, STI/HIV, depression, and other age-indicated screenings—status, ordered, or deferred. Immunizations - Vaccines due, administered today (lot/site per clinic workflow if documented), deferred, or refused with counseling. Anticipatory Guidance - Age-specific guidance provided (feeding, sleep, development, behavior, safety, puberty, mental health, etc.). Assessment - Well child / health supervision visit; growth and development assessment. - Any chronic issues or new concerns addressed today. Plan - Immunizations given/planned, screening orders, referrals (early intervention, dentistry, behavioral health, specialists). - Follow-up interval and return precautions for intercurrent illness.
When to use this template
What makes the structure useful, and which visits it fits best.
Why this template works
Structural advantages for real documentation
Best for
Visit types and clinicians who use this format
- Keeps development, vaccines, and anticipatory guidance as first-class sections.
- Supports caregiver concerns without turning the note into an acute HPI.
- Easy to adapt by age (infant, toddler, school-age, adolescent).
- Clear structure for Bright Futures–style preventive content clinicians expect.
- 1Routine well-child and health-supervision visits
- 2Vaccine and screening catch-up visits framed as preventive care
- 3Adolescent well visits with confidential interview elements
Example output shape
Illustrative excerpt of how a visit can land in this structure. Not a real patient record—review and edit every note before signing.
Visit Age / Context 18-month well-child visit. Caregiver concerns: picky eating and delayed single words (~5 words). Interval / Development No hospitalizations. Walks well; points to request objects; parallel play. ASQ completed by caregiver—communication domain borderline; other domains within cutoff. Growth / Exam Weight 11.2 kg (45th %ile), length 81 cm (40th %ile), HC 47 cm (50th %ile). Exam normal including dentition and gait. No ear effusion. Immunizations / Screenings Vaccines administered per catch-up schedule today (details in immunization record). Lead/hemoglobin risk screen reviewed—low risk; ordered per clinic protocol. Dental home discussed. Assessment / Plan Healthy 18-month-old with borderline language. Anticipatory guidance: language-rich interaction, limit solitary screen time, offer structured food exposures without pressure. Referral to early intervention speech evaluation placed. Return at 2-year well visit or sooner for illness/concerns.
How Wavo automates this
What the product actually does with your template.
2. Record or dictate
Capture the encounter with ambient recording or dictation. Wavo structures the note using your template.
3. Review and sign
Edit with Smart Transform if needed, then export or copy into your EHR. You stay responsible for the final note.
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Put this template to work on your next visit
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