These forms are requested for each new patient. For your convenience, please complete the forms and bring them with you on your first appointment. New Patient Forms Medical Records Release Form Treatment Consent Form

Behavioral Health Forms

ADHD Parent Follow-Up Form ADHD Parent Initial Form ADHD Teacher Follow-Up Form ADHD Teacher Initial Form SCARED Anxiety Screen (parents to complete) GAD-7 SCARED Anxiety Screen (child to complete) PHQ-9 (Modified for Teens)

MCHAT Edinburgh Postnatal Depression Scale PHQ-9 (Modified for Teens)

Pediatrician Patient Forms | Pediatric Associates PC

Printable Office Forms

Prior to your appointment, the forms listed below can be printed for your convenience. Filling them out beforehand will save you time by not having to complete them during your appointment. If you elect not to fill out these forms ahead of time, please arrive 15 minutes prior to your scheduled time. (You may download Adobe Reader for free at www.adobe.com.)

Patient Forms
These forms are requested for each new patient. For your convenience, please complete the forms and bring them with you on your first appointment.

New Patient Forms
Medical Records Release Form
Treatment Consent Form
Behavioral Health Forms
ADHD Parent Follow-Up Form
ADHD Parent Initial Form
ADHD Teacher Follow-Up Form
ADHD Teacher Initial Form
SCARED Anxiety Screen (parents to complete)
GAD-7
SCARED Anxiety Screen (child to complete)
PHQ-9 (Modified for Teens)
Well Check Forms
MCHAT
Edinburgh Postnatal Depression Scale
PHQ-9 (Modified for Teens)

602-861-1611

Forms

Printable Office Forms

Patient Forms

Behavioral Health Forms

Well Check Forms