- Telemedicine Session Patient Consent Form [ PDF ] [ Online Form ]
New Patient Forms
- ALL New Patient Forms (includes all other new patient forms below)[ PDF ]
- Patient Registration Form [ PDF ]
- [ Online Form ]
- Consent for Disclosure of Protected Health Information [ PDF ]
- Patient Billing and Financial Policy [ PDF ]
- Patient Acknowledgment and Consent [ PDF ]
- Patient Communication Log [ PDF ]
Patient Education
- Feeding Schedule [ PDF ]
- Immunization Schedule [ PDF ]
- Safety Checklist [ PDF ] [ Online Form ]
- Tip Top Teeth for your 1-2 Year Old [ PDF ]
- What is Flouride Varnish [ PDF ]
- Your 2-3 Year Old's Teeth are of Primary Importance [ PDF ]
- Your Baby's Developing Smile [ PDF ]
Other Forms
- Records Request Form [Online]
- PHQ-9 Depression Screening [Online]
- SCARED Child Version Anxiety Screening Tool (ages 8-18 years) [Online]
- SCARED Parent Version Anxiety Screening Tool (ages 8-18 years) [Online]
- Childhood Asthma Control Test for Children (ages 4-11 years) [ENG] [SPA]
- Asthma Control Test™ (ACT) for people 12 yrs and older [ENG] [SPA]
ADHD Forms
- Vanderbilt ADHD Diagnostic Form - Parent Informant [ PDF ] [ Online Form ]
- Vanderbilt ADHD Diagnostic Form - Teacher Informant [ PDF ] [ Online Form ]
- Vanderbilt ADHD Follow-up Form - Parent Informant [ PDF ] [ Online Form ]
- Vanderbilt ADHD Follow-up Form - Teacher Informant [ PDF ] [ Online Form ]
