Forms

Forms
IMPORTANT:
Please upload your completed forms to the patient portal at least 24 hours before your appointment.
Please do not upload individual photos of the forms. We prefer you scan and upload each form separately, all pages together.
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 (13-17)
If your child is between the ages of 13–17, 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-2021 (these forms are also available in the patient portal instead of downloading here)
Young Adult (18-22)
If you or your child are between the ages of 18–22, 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.
Young Adult Packet-2021 (these forms are also available in the patient portal instead of downloading here)
Adult (23+)
Adults (23+) 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-2021 (these forms are also available in the patient portal instead of downloading here)
Release of Information
Complete this release to allow us to send a questionnaire to a 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.