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SHA Surveys

We use these Staying Healthy Assessments to identify and document our patients' health education needs related to lifestyle, behavior, environment, and cultural and linguistic background. It is important to be honest when completing the forms so that we can most appropriately meet your needs.

SHAs (English)

Please print out the appropriate survey, fill it out, and bring it to your next visit with us. 

Adult

Children's Medical Group

500 S. Anaheim Hills Road, Ste 110

Anaheim, CA 92887

For Life-Threatening Emergencies Call 911
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© 2017 by Children's Medical Group. Created by Amanda Arbues and Updated by Tyler Yang

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