The following forms are informational. The first describes our policy concerning patient forms and the second is an informational reminder to new parents about adding a new child to an insurance policy.
Our providers may direct you to one or more of the following forms to aid in the diagnosis and/or treatment of various clinical situations.
Autism Screening Questionnaire: M-CHAT
Depression Screening Questionnaire: PHQ9
ADHD Questionnaire: Vanderbilt parent (initial)
ADHD Questionnaire: Vanderbilt teacher (initial)
Vomiting & Diarrhea Management and Hydration Tips
The following are forms concerning our flu season vaccination services. There are informational packets as well as consent forms for both types of vaccine.
*As of January 1, 2009, we will start charging $5.00 to complete all school, college and camp forms for our patients. The charge will be for each form requested and payment will be collected before the form is completed. We require between 3-5 business days to complete the forms. You may then either pick them up at the office of your choice or provide us with a self addressed stamped envelope for mailing. You will need to complete a HIPAA release form if you want us to mail the form anywhere other than your home address. Please be aware that if the form has specific lab requirements or immunizations you need to make sure these have been met before we can even complete the form. A delay in obtaining lab work will of course increase the time frame to complete your forms.