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Forms

We have moved to using electronic forms for most of our forms. Before your appointment, a message will be texted to your preferred phone on file with a link to the appropriate forms for the appointment.

Well Visit Handouts

Well Visit forms will be sent through our electronic text messaging system. Click below to access the information handouts by age group.

Records Release

Release for records coming to our office (Transferring In)

Release for records leaving our office (Transferring Out)

Release for medical information to be emailed or faxed (to send individual items to other locations such as your school or attorney)

Address Change Form

Healthcare Parental Proxy Form

If someone else is bringing your child into the office to be seen, you must fill out this form to give them to right to legally consent for care.

ADHD Forms

All ADHD Forms will be sent through our electronic text messaging system

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If you have any questions or issues related to the forms or would like to inquire about an ADHD evaluation you may request to speak with our Mental Health Coordinator after calling our phone line.

Flu Vaccine Screening E-form

To save time at your visit, fill out and print the flu vaccine screening form.

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