Forms

• New Patient Application
• Patient Registration Forms- Birth to 1 year
• Patient Registration Forms- 1 year to 18 years
• Parent Registration Forms
• Release of Medical Records (TO)
• Release of Medical Records (FROM)
• AHSAA Sports Physical Form
• Insurance and Office Policies

Civil Rights Policies

• Civil Rights Policy
• Procedure of Communicating with Persons of Limited English Proficiency Policy
• Section 504 Accessibility
• Non-Discrimination Policy
• Sensory Impairment Policy

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

Well Visit surveys are customized and sent to your patient portal based on your child's age. Please complete your survey(s) through your patient portal to ensure they are sent directly to your provider once complete! Contact our office staff prior to your appointment if you have questions about how to complete your child's survey(s). 

• MCHAT
• SCARED Anxiety Screen (parents to complete)
• Edinburgh Postnatal Depression Scale
• GAD-7
• SCARED Anxiety Screen (child to complete)
• PSC-17
• PHQ-9 (Modified for Teens)
• PHQ-9 (Adult)