Forms

If you plan on coming in for an appointment, please download all of the appropriate forms, and fill them out in advance. Or, you can fill these forms out in person on the day of appointment. All except for Biographical Information and the Consent to Obtain Information From, and the two questionnaires are required by law.

Complete either or both of the questionnaires only if they are relevant to your situation.

• ADHD Questionnaire - for Parent(s) to answer
• ADHD Questionnaire - for Teacher(s) to answer
• Anxiety Questionnaire - for parents to complete on their child (grades 3-12)
• Anxiety & Depression Questionnaire
• Biographical History
• Confidentiality
• Consent for Treatment of a Minor
• Consent to Obtain Information From
• Contact Information
• HIPAA Notice of Privacy Practices
• Informed Consent
• Insurance and Financial Responsibility