Forms

• Patient Portal: Finding your Forms 
• Patient Parent Portal registration
• Patient Portal Registration + 18yrs
• New Patient Registration Packet
• Family History Form
• HIPAA Notice of Privacy Practices
• Medical Records Release Form
• Patient Communication Form
• Prescription Refill Request Form
• Preparticipation Physical Evaluation Form
• Patient Consent for Use & Disclosure of Protected Health Information:18 Years of Age or Older

*By submitting your completed forms via email, you are acknowledging that you are sending protected health information via non-encrypted email and there is a risk that your health information could be compromised.

• MCHAT
• PHQ-9 (Modified for Teens)
• PHQ-9 (Adult)

• ADHD Parent Follow-Up Form
• ADHD Parent Initial Form
• ADHD Teacher Follow-Up Form
• ADHD Teacher Initial Form