Patient Forms  (steps 1-2 must be completed by all patients prior to appointment time)

1. Read our (1) PRIVACY POLICY/HIPPA, (2) FINANCIAL POLICY AND DISCLOSURE, and (3) PATIENT CONSENT FORMS below.
Once you read the forms, sign the signature form that you will be sent via email and/or text once you have scheduled your appointment.

• PRIVACY POLICY/HIPPA
• FINANCIAL POLICY and DISCLOSURE
• PATIENT CONSENT FORM

2. Please complete the Patient Information, Patient Medical History, and Insurance Forms that you will be sent via email and/or text once you have scheduled your appointment.

3. If your appointment is for a sleep evaluation, please complete the Sleep Questionnaire that you will be sent via email and/or text once you have scheduled your appointment.

4. Please send any pertinent medical records to us prior to your appointment.  A RELEASE OF MEDICAL INFORMATION FORM is provided below:

• RELEASE OF MEDICAL INFORMATION FORM

5. If your appointment is for an ADD/ADHD evaluation, please complete the parent and teacher Vanderbilt Scales linked below. We request (if possible) a form filled from each parent/caregiver (2 total) and a form filled from two separate teachers. Bring the completed forms to your appointment.

• PARENT VANDERBILT SCALE
• TEACHER VANDERBILT SCALE

6. TELEHEALTH – Please fill this form out if you are scheduling a telehealth visit. 

• TELEHEALTH FORM