Download forms

Prior to our first meeting, please download and fill out these forms.  Otherwise, plan to arrive about 20 minutes prior to your initial appointment to fill them out in our waiting room.   

 

If your child is being assessed, please fill out the following forms:

Child History Form 

Teacher Questionnaire (Please have each teacher fill one out)

Symptom Checklist (Please have each teacher, as well as each parent fill one out)

Limits of Confidentiality

Authorization Form

 

If you, or an adult family member are being assessed, please fill ou the following forms: 

Adult History Form

Limits of Confidentiality

Authorization Form