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.

1. Consent Checklist for Minor Children (rev 8/2020)- Please complete and print
2. New Patient Demographic Form (rev 8/2020)- Please print and complete
3. Patient Portal and CHADIS Form (rev 1/2021)- Please print and complete
4. Credit Card on File Form (rev 8/2020) - Please complete and print
5. Policies and Fees - (rev 4/2022)
6. Financial Policy  - (rev 8/2020)
7. 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.

• ADHD - Information for Families
• Vanderbilt Forms for Initial Parent and Teacher assessments
• Vanderbilt Forms for Follow-up Parent and Teacher assessments