Forms


For your convenience, please fill out the forms below before arriving for your appointment.  Most forms are in a digital format.  The Release of Medical Records Form is in a PDF format.  For PDF format, open in Adobe Acrobat, print, fill out and bring it to the office on the day of your child’s appointment.

Registration Form

Insurance Form

New Patient Medical History

Authorization to Treat

Release of Medical Records (PDF)

Ages and Stages Questionnaires:
We now have these questionnaires also in a digital format on the patient portal.  The patient portal refers to these questionnaires as surveys.  Once your child’s appointment is confirmed, the surveys will be listed as tasks to be completed.  Please keep in mind that some insurance plans apply the surveys to deductible/co-insurance or assess a copay.  If you have questions about your specific plan, we recommend you call your insurance carrier.

Office Policies:
For information about our Office, Financial and Privacy Policies please click the Office Policy link.