For Life-Threatening Emergencies Call 911

LEGAL DISCLAIMER
All advice provided on this website is for informational purposes only and is not intended to be, or serve as a substitute for professional medical or psychological advice, examination, diagnosis or treatment. Always seek the advice of your doctor or other qualified professionals with any questions you may have regarding a medical or psychological condition.

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Hanah Furfaro | 26-Jul-18

New Patients Form Download Page

  1. For pediatric patients (> 5 years of age) with problems related to attention, learning, behavior and mental health, download, print single-sided and fill out this form.
     

  2. For adult and young adult patients (> 14 years of age) with problems related to attention, learning, behavior and mental health, download, print single-sided and fill out this form.
     

  3. For young patients with autism, developmental concerns, or other health concerns use the Pediatric Healthy Living Consultation Form  (< 5 Years of Age).
     

  4. For patients with general health concerns use the Pediatric Healthy Living Consultation Form  (≥ 5 Years of Age).

  5. Use the Adult Healthy Living Consultation Form for general adult health concerns.

Please Print out All Forms Single-Sided and

Fill them Out Prior to the First Visit.