Forms

New Patient Forms

Patient Registration Form
Credit Card Authorization Form
Authorization to Release Protected Medical Information – Psychiatry
Authorization to Release Protected Medical Information – Neurology
Screen for Child Anxiety Related Disorders (SCARED) – Child Version
Screen for Child Anxiety Related Disorders (SCARED) – Parent Version
Generalized Anxiety Disorder 7-item (GAD-7) scale
DSM-5 Self-Rated Level 1 Cross-Cutting Symptom Measure Child Ages 11-17
Depression Scale
The Johns Hopkins Depression Checklist for Children HDCL-C
Parent Pre-Evaluation Form
Sleep Screening Questionnaire
NICHQ Vanderbilt Assessment Scale – PARENT Informant