Forms
Forms
IMPORTANT:
Please log into your portal as soon as possible to complete the forms. All of the forms can be completed online. We must have the forms completed at least 24 hours prior to your appointment. Some take a little time to complete, so please do not leave them for the last minute.
You may also choose to share other information with us, such as a previous evaluation, past records, teacher letters, or anything you believe may be helpful. Please do not send us pictures of the pages, but scan, label, and upload each document in its entirety. You may use the free APP Scanner Pro to scan your forms using your phone’s camera.
If you are sending all forms in one scan, please be sure they are in order, number them, and put your name on them. It is extremely difficult for us to work with single pages out of order, and will delay our ability to get you the evaluation report.
Child (6-12)
Adolescent (13-18)
If your child is between the ages of 13–18, click on the link below to download the Adolescent Packet. Please fill out all the forms within the packet and upload them to your secure patient portal at least 24 hours before your appointment.
Adolescent Packet-2023 (these forms may also be completed directly online in the patient portal instead of downloading here)
Young Adult (18-28)
If you are between the ages of 18–28, click on the link below to download the Young Adult Packet. Please fill out all the forms within the packet and upload them to your secure patient portal at least 24 hours before your appointment.
These forms are for the Modified Adult or Comprehensive Evaluation.
Young Adult Packet-2023 (these forms may also be completed directly online in the patient portal instead of downloading here)
Adult (29+)
Adults (29+) please click on the link below to download the Adult Packet. Please fill out all the forms within the packet and upload them to your secure patient portal at least 24 hours before your appointment.
These forms are for the Modified Adult or Comprehensive Evaluation.
Adult Packet-2023 (these forms may also be completed directly online in the patient portal instead of downloading heree)
Release of Information
Complete this release to allow us to send a questionnaire to your child’s teacher to be included in the evaluation, or to release the report or speak with your school, psychiatrist, or other healthcare providers.
Be sure to provide their name, email address, and phone number.
This form is also available in the portal and can be completed directly online.