Registration Forms (For New Patients and Well Visit Appointments)
Hipaa and financial Policy / Spanish Hipaa (Updated once a year)
Flu Clinic Consent Form - English
Flu Clinic Consent Form - Spanish
Well Visit Questionnaires and Forms
- 30 Month / 30 Meses
- 3 Years / 3 Años
- 4-6 Years Years / 4-6 Años
- Lead Assessment and Tuberculosis Screen / Evaluación del Plomo y Evaluación de la Tuberculosis
- Physical Form (If entering Kindergarten) / Spanish
- 7-11 Years / 7-11 Años
- Tuberculosis Screen / Evaluación de la Tuberculosis
- Physical Form (If entering 6th Grade) / Spanish
- 12-21 Years (Male) / 12-21 Años (Hombre)
- Tuberculosis Screen / Evaluación de la Tuberculosis
- Physical Form (If entering 9th Grade) / Spanish
- 12-21 Years (Female) / 12-21 Años (Mujer)
- Tuberculosis Screen / Evaluación de la Tuberculosis
- Physical Form (If entering 9th Grade) / Spanish
Miscellaneous Forms
Physical Form / Spanish (Required for kindergarten, 6th grade, and 9th grade and upon entering a new school or daycare)
Sports Physical Forms (If requested by school upon joining a sports team)
Vanderbilt Assessment Scale - Parent and Teacher Forms (Need at least two parent and two teacher forms required for ADD/ADHD initial evaluation appointments)
Medical Records Release (From our office)
Medical Records Release (To our office)