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As part of your Well Care, and under the guidelines of Bright Futures and the American Academy of Pediatrics, your doctors has asked that you complete the Nutrition Questionnaire. You can find the appropriate age form for your child below.

Optimal nutrition is important for sustenance, good health, and well-being throughout life. As the relationships among diet, health, and disease prevention have become clearer, nutrition and the promotion of healthy eating behaivors have received increased attention. The nutrition status of infants, children, and adolescents affects their growth and development and resistance to diseases. Lifelong eating behaviors and physical activity patterns are often established in early childhood. Therefore, it is important for children and adolescents to build the foundation for good health by choosing a healthy lifestyle, including practicing healthy eating behaviors and participating in regular physical activity.


Dr. Allan deVilleneuve, Dr. Carolyn Evans, & Connie Ray RN, CPNP

Related Documents:

Nutrition, Children 1yr – 10yr
Nutrition, Adolescents 11yr – 21yr