The Greig Health Record is the Canadian Paediatric Society’s preventive care guide for children and youth aged 6 to 17. This visit note covers the same ground, from growth and sleep to safety and vaccines. Copy the free template, see a 7-year-old in Ontario and a 15-year-old in British Columbia, and open the official CPS forms for each age group.
For clinicians in Canada.
Blank greig Health Record visit note template
FreeGREIG HEALTH RECORD VISIT NOTE, AGES 6 TO 17 Patient: [Name, age, pronouns] Date of birth: [Date] Visit date: [Date] Age group: [6 to 9, 10 to 13, or 14 to 17] Came with: [Parent or caregiver, or on their own] Clinician: [Name, credentials] BACKGROUND Family history and risk factors: [Early heart disease, high cholesterol, diabetes, mental illness, or substance use in the family] Allergies and medicines: [Allergies with reactions; regular medicines, vitamins, and natural health products] Since the last checkup: [Illnesses, injuries, emergency visits, new diagnoses] Concerns today: [From the child or teen, then from the parent] MEASUREMENTS Height and weight: [cm and kg, with percentiles on the WHO Growth Charts for Canada] BMI: [Value, BMI-for-age percentile, and the trend since the last visit] Blood pressure: [Reading, and how it compares with the norm for age, sex, and height] Vision: [Acuity in each eye; date of the last eye exam] Hearing: [Concerns, earbud volume, loud noise at work or play] SCHOOL AND DEVELOPMENT School: [Grade, report card, reading and math, learning or attention concerns] Friends and activities: [Friendships, bullying, sports, clubs, part-time job] Family: [Who lives at home, how they get along, discipline, recent changes] Puberty: [Body changes, periods and any problems with them, questions] NUTRITION, ACTIVITY, SLEEP, AND SCREENS Eating: [Breakfast, vegetables and fruit, sweet drinks, fast food, supplements] Body image: [Worries about weight or shape, dieting, skipped meals] Activity: [Minutes a day of moderate to vigorous activity; sports and walking or biking to school] Sleep: [Bedtime, wake time, hours a night, devices in the bedroom, snoring] Screens: [Hours a day outside school; social media and gaming] PSYCHOSOCIAL INTERVIEW, FROM ABOUT AGE 12 Confidentiality: [What stays private and when it can't, explained to youth and parent; minutes alone with the youth] Home, school, and friends: [The youth's own account] Mood: [Low mood, worry, stress; tool and score, such as PHQ-A or GAD-7] Self-harm and suicide: [Thoughts, plans, past attempts, access to means; or none] Substances: [Vaping, tobacco, alcohol, cannabis, other drugs; tool and score, such as CRAFFT] Abuse and violence: [Harm at home, at school, online, or in a relationship; or none] Sexual health: [Dating, orientation and gender identity if shared, consent, contraception and condoms, STI testing if sexually active] SAFETY In the car and on the road: [Booster seat until 145 cm and a good belt fit, seat belt, helmet, driving and riding with impaired drivers] Water, sun, and home: [Swimming ability, life jackets, sunscreen, smoke and carbon monoxide alarms, second-hand smoke] Firearms and online life: [Firearms at home and how they are locked; contact with strangers, image sharing] Other: [Trampolines, workplace safety, other topics for this age] EXAMINATION General: [Appearance, mood, how the child relates to you] Findings: [Head and neck, teeth, heart, lungs, abdomen, back and spine, skin and acne, genitourinary when indicated] Sexual maturity rating: [Tanner stage] PREVENTION Dental: [Last dental visit, brushing with fluoride toothpaste, sealants, mouthguard for sports] Immunizations: [Status against the provincial schedule, doses given today, school program doses still due] Influenza: [Given, booked, or declined] Tests only if indicated: [Lipids for a family history, STI testing, TB skin test for risk factors, hemoglobin or ferritin] ASSESSMENT AND PLAN Assessment: [Healthy child or teen, or the concerns found] Plan: [Each concern with its next step, referrals, and resources given] Advice given: [The age-specific guidance covered today, and what the family agreed to try] Shared with the parent: [What the youth agreed could be shared; or not applicable] Next preventive visit: [In 1 to 2 years, or sooner for follow-up] Signed: [Clinician name, credentials, date and time]
Use it for
Each one follows the template. Use them to judge how much detail every part needs.
Family practice in Ontario, preventive visit with his mother
7-year-old boy in Grade 2, here with his mother. No allergies; no regular medicines. One ear infection in the spring; no emergency visits. No early heart disease or high cholesterol in the family. His mother asks whether he still needs a car seat, and how much tablet time is too much.
Height 124 cm, 65th percentile. Weight 24.0 kg, 60th percentile. BMI 15.6, 55th percentile on the WHO Growth Charts for Canada, in the same channel as at age 6. BP 100/62, below the 90th percentile for his age, sex, and height. Vision 6/6 in each eye on a Snellen chart; last optometry exam 8 months ago, covered yearly by OHIP. No hearing concerns.
Reads at grade level; his teacher says he rushes through math. Two close friends; no bullying. Swims and plays house league soccer on Saturdays. Lives with both parents and a 4-year-old sister. Bedtime is a battle most nights. No signs of puberty.
Breakfast every day and a packed lunch; picky with vegetables. Milk 2 cups a day; a juice box most days. Active about 45 minutes on school days, more on weekends. Watches videos in bed and falls asleep around 10 p.m.; up at 6:45 a.m. for school, so under 9 hours on school nights. Recreational screens about 3 hours on school days.
Still rides in a forward-facing seat with a harness, but his shoulders are now above the top harness slot: he has outgrown it. Advised a high-back belt-positioning booster in the back seat. Ontario law allows a seat belt alone at age 8, 36 kg, or 145 cm, whichever comes first; advised keeping the booster until he is 145 cm and the adult belt fits. Wears a bike helmet. In swimming lessons; watched near water. Smoke and carbon monoxide alarms on each floor. No firearms at home.
Cheerful and chatty. Ear drums normal. Teeth: lower permanent incisors in, upper central incisors loose, first permanent molars through; no visible decay. Heart regular, no murmur. Lungs clear. Abdomen soft. Spine straight. Skin normal. Tanner stage 1.
Dental checkups every 6 months; brushes twice a day with fluoride toothpaste, with his mother’s help at night. Sealants for the new molars to raise with his dentist. Vaccines up to date for the Ontario schedule: Tdap-IPV and MMRV at age 4. Influenza vaccine given today. Next routine vaccines in the Grade 7 school program: hepatitis B, HPV, and meningococcal ACYW. No tests needed.
Healthy 7-year-old growing along his curves. Short sleep, linked to screens at bedtime. Plan: tablet charged outside his bedroom; screens off an hour before an 8:30 p.m. bedtime, for 9 to 11 hours of sleep; recreational screens under 2 hours a day; at least 60 minutes of active play daily. High-back booster this week. Water in place of juice at lunch. Next preventive visit at 8 or 9.
Family practice in British Columbia, yearly checkup, part of it alone
15-year-old girl in Grade 10, she/her, here with her father for a yearly checkup. The family moved from Kamloops to Surrey in the summer. No allergies; no regular medicines. No injuries this year. Her mother has been treated for depression. Her father says she “stays in her room all the time.”
Height 163 cm, 55th percentile. Weight 53 kg. BMI 20.0, 50th percentile, the same as at 13. BP 108/66, normal for age. Vision 6/6 in each eye. Wears earbuds several hours a day, often loud.
Told her and her father together that what she says stays between us, unless someone is at risk of serious harm or a child is being abused. Spoke with her alone for 20 minutes; her father came back for the plan.
Skips breakfast; eats lunch at school and dinner with the family. Happy with her body; no dieting. Stopped basketball after the move; walks 20 minutes to school. On her phone in bed until after midnight; up at 7 a.m., so about 6.5 hours of sleep. About 5 hours a day of social media and videos outside school.
Home: gets on with her father and stepmother; misses her mother, who stayed in Kamloops, and her old friends. School: grades down from Bs to Cs this term; one new friend; no bullying, in person or online. Mood: low most days for about 6 weeks, more irritable, tired, and no longer drawing. PHQ-A 11, with 0 on the self-harm item; no serious thoughts of ending her life in the past month and no past attempts. Asked directly: no thoughts of death or self-harm, now or before. Substances: tried a friend’s vape once in the summer; no alcohol or cannabis; CRAFFT 0. No abuse or violence at home, online, or with a partner.
Not dating; has not had sex. Knows she can get confidential sexual health care and counselling at Foundry without a parent. Periods every month for 5 days; no heavy bleeding; mild cramps.
Always wears a seat belt; plans to get her learner’s licence at 16. No firearms at home, confirmed with her father. Keeps in touch with old friends on group chats; doesn’t share images; knows how to block and report. Advised earbuds at no more than 60% volume, with breaks.
Quiet, good eye contact, flat affect. Thyroid not enlarged. Heart and lungs normal. Back: no curve on forward bend. Skin: mild comedonal acne on the forehead. Tanner stage 4.
Grade 9 Tdap and meningococcal ACYW given at school last year. Missed the Grade 6 HPV vaccine because the consent form wasn’t returned. She asked for it today; she understood the benefits and risks and gave her own consent, as BC’s Infants Act allows. One dose of HPV vaccine given: since July 2025, one dose completes the series in BC for ages 9 to 20. Influenza vaccine given. Dental checkup 4 months ago. CBC, ferritin, and TSH ordered for tiredness and low mood.
Healthy 15-year-old with 6 weeks of low mood after a move, in the moderate range on the PHQ-A; working impression adjustment disorder with depressed mood. No suicidal thoughts and no self-harm: low risk, so a safety plan isn’t needed now. Plan: with her agreement, referral to the local Foundry centre for counselling, and a call to her school counsellor. She chose to join the art club. Phone charged outside her room, aiming for 8 to 10 hours of sleep. Benzoyl peroxide 5% wash for acne. Crisis contacts given: 9-8-8, call or text, and Kids Help Phone. Shared with her father, with her agreement: the low mood, the referral, and the follow-up; not the vape. Follow-up in 4 weeks with a repeat PHQ-A, sooner if her mood worsens or any thoughts of self-harm start.
The Canadian Paediatric Society publishes the Greig Health Record at cps.ca, with a form for each age group, pages of selected guidelines and resources, and a technical report. Health professionals may reproduce the forms for office use; any other use needs the author’s permission. The forms were last updated in 2016, so check vaccines against your provincial schedule.
Measure at every preventive visit and plot on the WHO Growth Charts for Canada. The curve over the years tells you more than one point.
Avoid: Adult BMI cutoffs. A BMI of 23 sounds healthy, yet it sits above the 85th percentile for an 11-year-old.
How the child is doing at school, with friends, and at home. Falling grades or a lost friendship group is often the first sign of trouble.
Avoid: “Doing well in school” with no detail. Write the grade and what the report card or teacher says.
The daily habits behind growth, mood, and learning. The Canadian 24-Hour Movement Guidelines give the targets for ages 5 to 17.
Avoid: Advice with no numbers. “Asleep at 10, up at 6:45” shows the shortfall, and gives the family a target.
From about age 12, a HEEADSSS-style interview, with part of the visit alone after you explain confidentiality to the youth and the parent.
Avoid: A screen score with nothing after it. A PHQ-A in the moderate range needs your own questions about suicide and a follow-up date.
The injuries most likely at this age, and what the family is doing about them.
Avoid: Ending the booster at the legal minimum. Belt fit decides: lap belt low on the hips, shoulder belt across the middle of the shoulder.
Teeth, vaccines, and the few tests that depend on risk.
Avoid: Assuming school vaccines were given. A child who was absent, or whose consent form never came home, can miss a whole series.
Ontario lets a child use the seat belt alone at 8, 36 kg, or 145 cm, and other provinces set their own rules. Keep the booster until the child is 145 cm and the adult belt fits, which for most children is well past their 8th birthday.
Plot BMI-for-age on the WHO Growth Charts for Canada. Above the 85th percentile is overweight and above the 97th is obesity, whatever the number looks like on an adult scale.
The age forms list the vaccines of their day. Schedules have changed since: BC, for one, moved HPV to a single dose for ages 9 to 20 in 2025. Check the current provincial schedule and the child’s own record.
Teens rarely raise mood, sex, or substances with a parent listening. Explain confidentiality to both, spend part of the visit with the teen alone, and note what they agreed to share.
A quick visit for a camp or team form skips sleep, mood, safety, and vaccines. Book the full preventive visit, and complete the form at the same time.
Vero Scribe writes the visit note in your template from the conversation, with the family’s consent, or from your dictation. You review and edit every section, then copy it into your EMR or export it to Word or PDF. Vero works in 60+ languages.
An evidence-based preventive care guide for children and youth aged 6 to 17, written by Dr. Anita Greig and endorsed by the Canadian Paediatric Society and the College of Family Physicians of Canada. It was first published in 2010 and updated in 2016. There is a one-page form for each age group, 6 to 9, 10 to 13, and 14 to 17, and each item shows how strong the evidence behind it is.
From the Canadian Paediatric Society’s website, at cps.ca/en/tools-outils/greig-health-record, as a PDF for each age group. The three forms are linked on this page. Health professionals may reproduce them for office use; other uses need the author’s permission. The template here is a separate visit note, for your EMR or for Vero, that covers the same areas.
The Greig forms suggest a visit every 1 to 2 years in each age group. Many family physicians and pediatricians see children yearly, and sooner when there is a concern about growth, mood, or school.
The focus moves from the family to the young person. At 6 to 9: booster seats, sleep, screens, discipline, and water safety. At 10 to 13: puberty, mood, a first part of the visit alone, and the school-program vaccines. At 14 to 17: a full psychosocial interview alone, sexual health, substances, driving, and safety at work.
Yes. Copy it, or download it as a Word or text file. No account needed.
The sick-visit SOAP note for children, with caregiver history, hydration, and weight-based doses.
Growth, development, screening, vaccines, and safety guidance, with 12-month and 5-year examples.
Milestones by domain, ASQ-3 and M-CHAT-R/F results, corrected age, and the refer-or-rescreen decision.
The diagnostic report after an autism assessment: history, ADOS-2 and other results, DSM-5-TR criteria, support levels, and recommendations.
Well-baby visits from birth to 5, organized like the Rourke Baby Record, with a BC 2-month and an Ontario 18-month example.
Preventive and sick-visit notes from child and family conversations.
The adolescent psychosocial interview, from home life to safety online.
The codes used most often in pediatrics.
Vero writes your notes and letters in the templates you choose, so you review instead of type.
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