Forms & Questionnaires
Clinical service forms
If you are new to our clinic and have an appointment, please review and fill out all the below forms. These forms will assist in making your check in process quick and easy.
Child History Form
Health History Profile
Patient Information Sheet
Questionnaires can assist your provider in assessing and developing a treatment plan for your child.
Language Questionnaire-Autism in Toddlers (AGRE)
Modified Checklist for Autism in Toddlers- (M-Chat)
Mood and Feeling Questionnaire
Pediatric Symptom Checklist
Screen for Child Anxiety-Related Disorders — Child (SCARED)
Screen for Child Anxiety-Related Disorders — Parent (SCARED)
Yale-Brown Obsessive Compulsive Scale