We recommend yearly checkups for your big kids.  We measure growth, perform hearing and vision screening.  We recommend following the CDC schedule for immunizations, which completes the primary series by age 4.  We preferentially use preservative-free combination vaccines, to minimize the number of injections that a child receives at a time.  

We also do separate appointments for behavior concerns, such as ADHD and anxiety.  These appointments are scheduled separately from well visits.