Dear Birth to Three Families, 

With fall just around the corner, we are working diligently to provide all of our loyal patients with the best possible appointment schedule.

To help us accommodate your needs, we kindly ask that you provide at least three preferred days and time ranges when you are available for appointments. While we will do our very best to honor your preferences, please note that we may not be able to fulfill everyone’s first choice.

Child's Name(Required)

Home Availability

Please select your child’s availability for each time interval
Monday
Tuesday
Wednesday
Thursday
Friday

Child Care Availability (if applicable)

Please select your child’s availability for each time interval
Monday
Tuesday
Wednesday
Thursday
Friday
If so, please provide them below.