Downloadable Registration and Information Forms
These are registration forms. If you do not do an Online Registration, you may download these, print them, fill them out, and bring them to your evaluation. HIPPA information is included in this packet, and review of this information is required to complete the Online Registration.
These are ADHD Checklists for child and adolescent ADHD evaluations. One is for parents and the other for teachers. Download these and have them completed prior to your evaluation.
This is an information form to be completed by either adult patients or the parents of child/adolescent patients. Please fill this out and bring the form to your evaluation.
These files are in .PDF format and can be open with Adobe Reader, which can be downloaded HERE.
CREDIT CARD AUTHORIZATION FORM
We require patients to have a credit/debit card on file to cover unpaid deductibles or co-payments. Once your insurance has paid, we will charge your credit card for the remainder.
You must download this form and bring the completed form to your initial appointment in order to receive services.
Downloadable ADHD Checklists