Forms and Policies
Click on the appropriate forms below. If you are a new patient, please complete the forms that have a star (*) next to it and bring them to your appointment; along with patient(s) insurance card. This will help speed your check in process. Thanks for your cooperation.
- New Patient Registration - English **Please fill out one registration form per family**
- New Patient Registration - Spanish
- Medical Release Form
(Please complete if you are requesting records from another doctors office to be sent to our practice) - Authorization Consent for Disclosure of Protected Health Information
(Please complete if you are transferring out of our practice and would like us to forward your records to your new provider) - Preparticipation Physical Examination Form
(Please complete prior to your physical and bring to our office at time of exam) - HIPAA Notice of Privacy Practices
(Your rights as a patient) - Immunization Consent Form
- ADHD Teacher Questionnaire
(Vanderbilt Assessment Scale) - ADHD Parent Questionnaire
(Vanderbilt Assessment Scale)