First Visit Patient Forms
Choose the form that best describes you or your child and print single sided. Fill out and bring them to your first visit.

Form AFor pediatric patients > 5 years of age with problems related to attention, learning, behavior, and mental health
 

Form BFor adults and young adult patients > 14 years of age with problems related to attention, learning, behavior, and mental health
 

Form CFor young pediatric patients < 5 Years of Age with autism, developmental concerns, or other health concerns

Form DFor patients ≥ 5 Years of Age with general health concerns

Form E : For adult patients general health concerns