To expedite your first appointment, please print and complete registration forms so that we have all the necessary information to treat your child.
New Family Initial History Questionnaire
Items 1-4 below need to be completed and returned to us.
Items 5-7 below are for your information and do not need to be returned to us.
- Consent Checklist for Minor Children (rev 8/2020)- Please complete and print
- New Patient Demographic Form (rev 8/2020)- Please print and complete
- Patient Portal and CHADIS Form (rev 1/2021)- Please print and complete
- Credit Card on File Form (rev 8/2020) - Please complete and print
- Policies and Fees - (rev 4/2022)
- Financial Policy - (rev 8/2020)
- Notice of Privacy Practices - (rev 8/2020)
Adolescent (11-17y) Patient Portal Form
Request for Release of Medical Records (from another Dr. to us)
HIPAA Privacy Form (Patients 18y or older) - To be completed by the 18+yr old Patient
You may be asked to bring in a completed parent and/or teacher Vanderbilt form for your child's upcoming ADHD appointment. You can find these forms by clicking on the links below.
Contact Us

Please use the phone or fax number below to contact the office:
Phone (301) 774-4100
Fax (301)774-7648
Monday: | 08:30 AM - 05:00 PM |
Tuesday: | 08:30 AM - 05:00 PM |
Wednesday: | 08:30 AM - 05:00 PM |
Thursday: | 08:30 AM - 05:00 PM |
Friday: | 08:30 AM - 05:00 PM |
Saturday Sick Hours: | 08:30 AM - 11:00 AM |