Guthrie County Hospital

Make your clinic visit quicker by filling out the appropriate paperwork below prior to your visit.

Annual Wellness Visit

Daycare/Preschool Physical

New Patient Form

Sports Physical

Well Male Questionnaire

Well Woman Questionnaire

DOT Physical Questionnaire/Form

• DOT Physical Check List
• FMCSA FORM MCSA-5875 (please fill out pages 1-2)
• STOP Sleep Apnea Screening

Well Child Exams

• 18-21 years old
• 15-17 years old
• 11-14 years old
• 10 years old
• 9 years old
• 8 years old
• 7 years old
• 6 years old
• 5 years old
• 4 years old
• 3 years old
• 2.5 years old
• 2 years old
• 18 months old
• 15 months old
• 12 months old
• 9 months old
• 6 months old
• 4 months old
• 2 months old
• 1 months old
• 2-5 days old