Pediatric Functional Medicine – Cooper Family & Pediatric Chiropractic

A closer look at your child’s health

Fill out our short, guided assessment, below, that helps us understand what’s really going on – sleep, digestion, energy, sensitivities – so we can spend your appointment on answers, not just questions.

Takes about 5-10 minutes. Answer based on your child’s usual pattern over the last few months, there are no wrong answers. At the end, you’ll get a summary you can print, save or bring with you to your visit.

Why we ask this

You’ll notice these questions go beyond the usual checklist : sleep, energy, digestion, sensitivities, recovery after activity. That’s intentional. Kids’ bodies often show what’s going on through patterns like these before it shows up as a diagnosis. This assessment helps us see the whole picture, not just the loudest symptom.

Your answers stay in the browser while you complete this, nothing is saved or sent anywhere until you chose to email or print your results.

Ready to talk through what you found?

Book a new patient visit

Already a patient ? Book here

Bring your printed or emailed summary with you, it’ll help us make the most of your appointment.

Is this a diagnosis?

No. This is a screening tool, not a diagnosis-it helps organize what you’re noticing so your visit can start with a clearer picture. Any next steps come from a real conversation with your provider, not from this assessment alone.

What if I’m not sure how to answer something?

Go with yours best sense of your child’s usual patterns, not a single bad day or a single good week. If you’re genuinely torn between two answers, pick the one that’s been true more often lately.

Do I need to finish it in one sitting?

It’s built to take 5-10 minutes, but nothing is saved automatically as you go, if you close the page partway through you’ll need to start over.

What happens to my answers?

Nothing is transmitted or stored anywhere while you’re filling it out, it all stays non your browser. At the end you choose whether to print it, save it as a PDF, or email it to yourself or to us.

My child is very young/a newborn does this still apply ?

Yes, it’s built to cover the full range from newborn through 18, and the questions are meant to be answered based on what youn observe as a their parent or caregiver.