Patient Resources
Helpful forms, documents, and health information for your family
New Patient Forms
Download and complete these forms before your first visit
| Form Name | Description | Download | |
|---|---|---|---|
| HIPAA Patient Questionnaire | Privacy practices and emergency contact authorization | ||
| Authorization for Treatment | Consent for medical examination and treatment | ||
| Medical Records Authorization | Authorization to use and disclose medical records | ||
| New Patient Registration Form | Complete patient information and medical history | ||
| Notice of Privacy Practices | HIPAA privacy policy and patient rights | ||
| School Entry Health Exam | Florida state-required health examination form | ||
| Vanderbilt Assessment - Parent | ADHD assessment follow-up form for parents | ||
| Vanderbilt Assessment - Teacher | ADHD assessment form for teachers | ||
| ASQ-3: 18 Months (Spanish) | Ages & Stages developmental questionnaire | ||
| ASQ 9mos English.pdf | Ages & Stages developmental questionnaire | ||
| ASQ-3: 9 Months (Spanish) | Ages & Stages developmental questionnaire | ||
| M-CHAT (English) | Modified Checklist for Autism in Toddlers | ||
| M-CHAT (Spanish) | Modified Checklist for Autism in Toddlers | ||
| Sports Physical (FHSAA EL2) | Florida High School Athletic Association physical form |
Helpful Health Resources
Trusted sources for pediatric health information
| Resource Name | Description | Link | |
|---|---|---|---|
| American Academy of Pediatrics | Official AAP website with pediatric health guidelines and research | Visit | |
| HealthyChildren.org | Parent-friendly health information from the AAP | Visit | |
| Poison Control Center | 24/7 emergency poison help and prevention information | Visit | |
| CDC | Centers for Disease Control and Prevention health guidelines | Visit | |
| National Domestic Violence Hotline | Support and resources for domestic violence situations | Visit |