Forms

Office Forms

These forms will be available through the patient portal. Please complete them prior to your visit to help streamline your visit.

**If you elect not to fill out these forms ahead of time, please arrive 20 minutes prior to your scheduled time.

Registration Forms

• Office Policy
• Financial Policy
• AI Consent Policy
• HIPPA Policy
• Email, Text and Voicemail Consent

Well Check Screening Questionnaires

Screening Questionnaires will be available on the Patient Portal for the indicated well child visits.

• Edinburgh Postnatal Depression Scale
• Ages and Stages Questionnaires
• M-CHAT (Modified Checklist for Autism in Toddlers)
• PSC-17 (Pediatric Symptom Checklist 17)
• PHQ-9 (Patient Health Questionnaire-9)
• GAD-7 (General Anxiety Disorder - 7)
• SCARED Anxiety Screen (Screen for Child Anxiety Related Disorders)

Behavioral Health Forms

• ADHD Parent Initial Form
• ADHD Parent Follow-Up Form
• ADHD Teacher Initial Form
• ADHD Teacher Follow-Up Form