As the lazy days of summer wind down, beach trips, lemonade stands and lax bedtimes give way to alarm clocks, textbooks and backpacks. Public health officials say that a back-to-school list should include more than pencils and paper. For many, the first order of business is a well-child physical, a dental exam and required immunizations.

During a physical exam, parents should double check that immunizations are up to date, ask if their child’s growth is on target and what normal developmental changes they should expect during the next year. Parents should also be prepared to answer questions about their child’s sleep patterns and eating habits.

“Vision checks are an important part of a routine school entry physical so make sure to ask for one,” said Caroline Sutter, a family nurse practitioner, DNP-BC, co-director of Mason and Partners (MAP) clinics and an assistant professor of nursing at George Mason University in Fairfax. “Dental exams are important to maintain health. Ask for a referral for a dental visit.”

George Mason University’s College of Health and Human Services runs MAP clinics, which offers school entry physicals at no cost.

The Fairfax County Health Department provides free school-required immunizations at five locations in the county. “We are offering some special extended hours in August and September to accommodate the back-to-school rush, but we recommend that parents make the appointment now,” said John Silcox, public safety information officer, Fairfax County Health Department.

In conjunction with Inova Health System’s Partnership for Healthier Kids, the Fairfax County health department also offers free physicals for school entry to uninsured children. The health department also operates three dental clinics that provide services to children based on eligibility.

“We operate three health centers in Falls Church, Alexandria and Reston that provide primary health services for low income, uninsured residents who cannot afford primary medical care services for themselves and their families,” said Silcox.

Dental services are available for eligible children in Arlington through high school age. Vaccines required by Arlington County Public Schools are also available free of charge.

In Alexandria, the Child Health Clinic provides preventative health services for infants and children through age 5, and physicals for daycare and school entrance through age 11. The Alexandria Health Department offers routine immunizations for infants, teens and adults.

The Montgomery County Maryland, Health and Human Services Department offers an Immunization Program with walk-in immunizations to children under the age of 19. The county also offers dental care for children ages three to 18.

Sutter says proper sleep and physical activity are also part of the pediatric health care picture and should not be overlooked. Transitioning from a summer of sleeping late to a school year of early wake-up calls can be challenging if children are not prepared. “Establish a sleep schedule now,” said Sutter. “With summer coming to an end, it is important to get kids on a regular sleep schedule before school starts.

“Stress the importance of routine physical activity with your child,” she continued. “Talk about sports they might be interested in during the school year or other ways to stay physically fit but most important set a good example. Exercise regularly yourself or with your children.”

For those experiencing anxiety about returning to school, Sutter suggests addressing the issue before the first day of school. “Come up with a good plan to address them,” she said. “Talk to your children about kindness and what to do if he or she is a victim of bullying and how to ask for help if needed.”