Forms

Get Started

 

For new patients, paperwork is due 2 weeks before your child’s appointment - please complete your child’s new patient paperwork digitally using the link sent through PracticeQ/IntakeQ after booking your appointment. If you have any difficulties, please call the office.

For existing patients, if you need to update your release of information or the email address one file, the below forms can also be downloaded for updates as needed or filled out through your online portal

Release of Information - Child

Email Waiver

If an adult that is not your child’s legal guardian will be accompanying them to any follow up visits, please complete the form below:

Authorization for Non-Parent

Our HIPAA Notice of Privacy Practices is available for review here

“All children have within them the potential to be great kids. It’s our job to create a great world where this potential can flourish.”
— Stanley Greenspan, MD