Patient Resources
Clinic Forms & Documents Patient Education Patient Portal Tutorials
Clinic Forms and Documents
You can bring completed forms with you, or to expedite your check in process, email them ahead of your appointment to patientresources@sunsetpediatrics.com.
If you are requesting forms be signed by the physician and returned to you, please include your email in your message as our secure email service masks that information.
New Patient Packet
Consent to Treat Form
Medical Release Form (from Sunset)
Medical Release Form (to Sunset)
Adult Patient Release Form – used for patients over 18 who wish their parents to be able to contact Sunset regarding their medical care.
Notice of Privacy
Financial Policy
Patient Portal Forms – Sign up for the patient portal by filling out these forms. Fill out one form per child seen at Sunset.
Developmental Screenings
M-Chat Questionnaire for Toddlers
9 Month Questionnaire
18 Month Questionnaire
24 Month Questionnaire
11+ Adolescent Questionnaire:
At each Well Child Check, once your child turns 11, the pediatricians at Sunset Pediatrics strongly recommend that your child complete an adolescent questionnaire. Per Oregon Health Authority guidelines, we use a well-studied and validated questionnaire called the SBIRT (CRAFFT & PHQ 2/9). The SBIRT is a universal screening that quickly detects anxiety, depression, substance use disorders, and the risk of developing them. It also provides insight and awareness regarding risky behaviors and can help your child’s pediatrician refer them to any additional help they may need.
We ask that your child completes the form in private, however, they will discuss the answers with their pediatrician. If you have any questions or concerns, please ask your child’s doctor.
The Oregon Health Authority is working to standardize billing and payment for all insurance payers. However, please be aware that the coding and billing policies for the SBIRT are a work in progress, and are currently billed separately from your child’s Well Child Check. This may result in a balance for the responsible party of up to $40.
Immunization Schedule
2019 Recommended Well Visits and Immunizations
Patient Education
Newborn to 1 year:
Online Resources:
- AAP’s HealthyChildren.org (English)
- CDC website: Developmental Milestones
- Children’s Hospital of Philadelphia: Vaccine Education Center
- CDC website
- Stomach and Intestine Issues
- Child Safety Seat
- Child Passenger Safety
- The Oregon Poison Center
The Oregon Poison Center 1-800-222-1222 is a 24-hour regional poison emergency information and resource center for the public and health care professionals. - American Red Cross
- Baby Blues
- Maternal Mental Health
Books:
- Your Baby’s First Year by American Academy of Pediatrics
- Caring for Your Baby and Young Child: Birth to Age 5, by American Academy of Pediatrics
- Heading Home with Your Newborn: From Birth to Reality, by American Academy of Pediatrics
- Happiest Baby on the Block
- Sleep: What Every Parent Needs to Know
- Baby 411
- Top 100 Baby Purées: 100 Quick and Easy Meals for a Healthy and Happy Baby, by Annabel Karmel
- Healthy Sleep Habits, Happy Child, by Marc Weissbluth
Childhood:
Online Resources:
- AAP’s HealthyChildren.org
- Bullying
- CDC website: Developmental Milestones
- Children’s Hospital of Philadelphia: Vaccine Education Center
- CDC website
- Stomach and Intestine Issues
- Child Safety Seat
- Child Passenger Safety
- Positive Reinforcement
- Printable Behavioral Reinforcement Charts for Children
- Tips for Communicating with Your Child
- USDA Nutrition Guidelines for Children
- The Oregon Poison Center
The Oregon Poison Center 1-800-222-1222 is a 24-hour regional poison emergency information and resource center for the public and health care professionals. - American Red Cross
Books:
- Love and Logic
- The Wonder Years: Helping Your Baby and Young Child Successfully Negotiate the Major Developmental Milestones, by American Academy of Pediatrics
- Caring for Your Baby and Young Child: Birth to Age 5, by American Academy of Pediatrics
- Incredible Years: A Troubleshooting Guide for Parents of Children Aged 3 to 8, by Carolyn Webster-Stratton
- Parenting That Works: Building Skills that Last a Lifetime, by Edward R. Christophersen & Susan L. Mortweet
- Wild Things: The Art of Nurturing Boys
- Parenting the Strong-Willed Child, by Rex L. Forehand and Nicholas Long
- Raising Your Spirited Child: A Guide for Parents Whose Child Is More Intense, Sensitive, Perceptive, Persistent, and Energetic, by Mary S. Kurcinka
- Raising Your Spirited Child Workbook, by Mary S. Kurcinka
- The Berenstain Bears Learn about Strangers, by Stan & Jan Berenstain
- SOS! Help for Parents: A Practical Guide for Handling Common Everyday Behavior Problems, by Lynn Clarke
- Tobin Learns to Make Friends, by Diane Murrell
- Volcano in My Tummy: Helping Children to Handle Anger, by Warwick Pudney & Elaine Whitehouse
- Your Defiant Child: 8 Steps to Better Behavior, by Russell Barkley and Christine Benton.
- Puberty/Girls: The Care and Keeping of You
- Puberty/Boys: The Boys Body Book
Teens:
Online Resources:
Additional:
Immunization Resources:
- American Academy of Pediatrics
- CDC National Immunization Program
- Institute for Vaccine Safety at John Hopkins University
- Allied Vaccine Group
- Recommended Immunizations from Birth-6 Years Old
- Recommended Immunizations from 7-18 Years Old
- New Immunization Exemption Rules – March 1, 2014
Travel Vaccines:
Sunset Pediatrics does not carry or administer travel vaccines. For travel vaccines and information, please contact one of the clinics listed below.
Travel & Immunization Clinic of Portland
2330 NW Flanders, # 103
Portland, Oregon 97210
503-227-7771
Providence St. Vincent’s Traveler’s Clinic
9155 SW Barnes Road #638
Portland, OR 97225
503-216-7000
Providence Portland Traveler’s Immunization Clinic
5050 NE Hoyt, # 540
Portland, Oregon 97213
503-215-6405
Multnomah County Traveler’s Clinic
426 SW Stark #9
Portland, Oregon 97204
503-988-3406, option 5
OHSU Family Medicine at Gabriel Park – Travel Clinic
4411 SW Vermont Ave
Portland, OR 97219
503-494-9992 for appointments
For additional information on travel and vaccines, please visit www.cdc.gov/travel
Dosage Charts
