Patient Forms

Forms Requested Prior to Your Initial Visit

  • Demographics Form
  • Release of Medical Records 
    • If you would like us to reciprocate information with another facility or provider please complete this form.  This might include your primary care provider, radiology services, other specialists.
  • Parent Questionnaire (see below)

Parent Questionnaires

Additional Forms for Evaluation and Management of ADHD

(Please see "resources" for form information on ADHD evaluation and management)

Useful forms prior to your first appointment

Follow up forms

Forms That Will Be Provided At Your Appointment

  • Authorization to Treat a Minor
  • Financial Agreement
  • Consent to Use and Disclosure of Protected Health Information
Everything was incredibly efficient and made sense. We really felt that the thorough patient paperwork questionnaire helped the doctor and us (and our daughter!) to connect.