Forms

 REGISTRATION/AUTHORIZATION

Demographic Information Form

Datos Demograficos del Paciente

Authorization for Medical Treatment with Caregiver other than Parent/Legal Guardian

Autorizacion de Poder Para Tratamiento Medico Con Un Cuidador Que No Sea El Padre/Tutor Legal

Authorization for 16-17 Year Old Minor to Receive Treatment Without Parent/Legal Guardian

Authorization to Release Medical Information

Authorization for Mode of Reporting Normal Test Results

Consent to Treat Minor Children

ATTENTION DEFICIT/HYPERACTIVITY

ADHD (Attention Deficit/Hyperactivity Disorder) Initial Parent Survey

ADHD (Attention Deficit/Hyperactivity Disorder) Initial Teacher Survey

Vanderbilt ADHD Initial Parent Survey

Vanderbilt ADHD Initial Teacher Survey

Vanderbilt ADHD Follow Up Parent Survey

Vanderbilt ADHD Follow Up Teacher Survey

Adult ADHD Symptom Checklist

DEVELOPMENTAL SCREENING 

M-CHAT (Modified Checklist for Autism in Toddlers)

M-CHAT (Spanish: en Espanol)

MENTAL HEALTH SCREENING/ASSESSMENT

Depression Scale for Children

GAD-7 Anxiety Survey

GAD-7 Anxiety Survey (Spanish)

PHQ-9 (Modified) Depression Survey

PHQ-(Modified) Depression Survey (Spanish)

SCARED Anxiety Survey (Child Informant) 

SCARED Anxiety Survey (Parent Informant)

SCOFF Eating Disorder Survey

SPORTS PRE-PARTICIPATION 

FHSAA "Sports Physical" Form