General Appointment Information 

  • Visit slots vary in duration and times when they are offered depending on the type.
  • You may need several visits to completely cover the topics we need to discuss about your child.
  • ALL of our Well Check visits are scheduled with our Nurse Practitioners
  • ALL of our Same Day Sick visits are scheduled with our Nurse Practitioners
  • Dr. Carine handles our patient’s more complicated, ongoing, chronic, or special needs visits, as well as osteopathic treatments.  The Nurse Practitioners are overseen by Dr. Carine and she is used frequently as a resource  throughout the day/week especially when they encounter something with which they have little experience, or strong concerns.
  • We request that you bring your child to EVERY visit.  If a practitioner does not need to assess your child for the visit, they will give you specific directions regarding that, and it will apply ONLY that occasion.  Your child’s health is best served is we pair physical assessment along with any behavioral, mental, or emotional symptoms.  If you feel that you cannot give enough attention to either your child, or the practitioner during discussion while you child is in the visit, OR if you would like to discuss something you do not wish you child to hear, we ask that you bring help along.  Another parent or adult who can entertain your child during the visit, or else accompany your child to the play room.  Our staff make every effort to keep your children safe while they are in the office, but ultimately each staff member has tasks they are performing which prevents them from being solely responsible for your child(ren) while they are in our office.

Well Check Visits

  • Well Checks, or Well Child exams, are intended to address overall basic health questions, to fill out school forms and to address preventative topics such as vaccines.  Ongoing chronic conditions and acute ill symptoms are not intended to be reviewed at Well Check visits (this is defined by our government’s visit codes and reimbursement structures).  If, during the routine exam, symptoms are discovered they must be documented, and therefore they will be reflected in the billing of the visit.  If you believe you child  is sick, please call to reschedule your Well Check, or change it to a Same Day Sick visit.
  • Our schedule allows for only 2 siblings to have consecutive Well Checks on a given day.
  • Well Checks are due at the following ages: Birth, 1 month, 2 months, 4 months, 6 months, 9 months, 12 months, 15 months, 18 months, 2 years, 2.5 years (IF your insurance offers coverage), 3 years, and once a year, every year after that.

Same Day Sick Visits

  • Same Day Sick visits are intended to address acute (sudden onset, short duration) symptoms your child is experiencing - NOT chronic/recurring issues.  Proper notification of the staff, when arranging the appointment, is needed to ensure there is enough time allotted to address the concerns you have.
  • We leave time in our schedule, and often stay late hours, to ensure that any child in our practice who has an acute illness can be seen that day.  We hope that this will limit your need for urgent care visits with doctor who has no knowledge of your child and their history.  Please call as early as possible to make these Same Day Sick appointments, or email the office the night before.

Conference Visits

  • Prearranged “ill” visits, these are intended either address or follow up on chronic health concerns.
  • Please be tactful and respectful when discussing areas of emotional or behavioral trouble your child is experiencing while the child is present.  We try to remain as positive as possible during children’s visits.

Med Check Visits / Prescriptions

  • Chronic maintenance medications are usually given refills until the next time we need to see the child in follow up.  If your child is out of refills, it is best to schedule a re-check appointment.  This is especially true of asthma medications.
  • Controlled substances, such as ADHD medications, are regulated by the DEA.  Regular Med Check appointments are required and we can now offer e-prescriptions (except on rare occasions).  Do not wait until the child is out of medication to call us, you need to give us at least 2-5 business days notice.
  • If your child is on a controlled medication they must be seen in our office every 3 months (90 days).  We CANNOT refill controlled medication for a child we have not seen and assessed within the last 3 months (90 days).  These are strong medications which can greatly effect your child’s health, and therefore need to be monitored by a health care professional.  You child MUST be present at the follow-up/recheck/Med Check visits.

Osteopathic Manipulative Treatment (OMT) Visits

  • Osteopathic Manipulation Treatments (OMT) visits are scheduled into 30-minute time slots.  Occasionally these OMT visits can include a brief, simple discussion, however, in-depth discussions should be arranged for another day.  Dr. Carine needs to focus her attention on the needs of your child, both interactively and osteopathically to ensure he or she receives the best care possible.
  • Dr. Carine is the only practitioner in our office who can perform OMT for our patients, it is therefore prudent to schedule them in advance.  Her schedule is routinely full 4-8 weeks in advance.

Shot Only Visits

  • If your child has had the most recent Well Check already, and just needs a vaccination, please call to schedule a Shot only visit.  These visits WILL generate an office visit, which your insurance may or may not cover.  You may also have a copay for this type of visit.  USUALLY, insurance does cover the cost of the vaccine itself as well care, but this is dependent on your insurance coverage.  Therefore, any questions about coverage should be directed to your insurance provider.
  • If your  child has not had the most recent Well Check, we will NOT schedule a Shot only visit.  We believe Well Checks are part of the most beneficial way to care for your child, and help us provide the best health care possible to them.  Therefore, if we are your primary care provider, we do require that you schedule, and attend all your child’s Well Checks.
  • Please refer to our Vaccination Policy for further details/limitations on scheduling/requesting Shot only visits at our office.

We do NOT offer Phone/Email/Skype Consultations

  • While we would love to address as much as possible in these formats, insurance does not, as yet, pay appropriately for services provided in this manner.  While we know many of you would prefer to pay cash to receive a consult by phone/email or skype, to avoid a visit to the office with your child, missing work, and all that is entailed to make an in-person visit, it simply isn’t possible at this time.  We are working diligently to try to make phone/email/skype consults available to you, especially to address lab work, behavioral concerns, and chronic conditions.  Unfortunately, at this time, phone and email will be used only for simple, quick discussions, and anything of substance will need to be seen in the office.  We will keep you posted on our progress on this important topic.
  • If you email a question or leave a message, we will offer what guidance we can.  There are, however, MANY occasions when we simply cannot offer medical advice over the phone, or through email.  We may need our practitioners to assess the patient/symptoms.  We will NOT endanger your child, compromise our integrity, or put our office staff and patient population at risk by providing services which can only safely be rendered AFTER a patient is seen and assessed.


  • Nationwide Children’s referrals must be made through our office, for physicians outside the hospital we will often encourage you to check your plan and make those appointments yourself.
  • Referrals are generally not urgent health concerns, and therefore may take 2-5 business days to submit.  On the rare occasions that they are urgent we will act accordingly.