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ADMISSION FORMS:

Please complete and sign the Registration Form, Office Policies form and Notice of Privacy Practices.  For minors, complete the Parent Questionnaire. Youngsters >14 YO and adults need to complete the Patient Questionnaire. It's important that you take time to complete and accurately respond to the questions. Bring these forms and questionnaire to your first appointment.

Patient_Questionnaire.pdf
Parent_Questionnaire.pdf

CLINICAL FORMS:

The following forms are complementary and can greatly facilitate your examination or examination of the child. Please go over the list and complete the ones that best apply to your case.

For youngsters presenting primarily with attention and behavioral difficulties, complete the Vanderbilt Parent Scale and ask the teacher to complete the Vanderbilt Teacher Scale.


Vanderbilt_Parent_Scale.pdf
Vanderbilt_Parent_Scale_Spanish.pdf
Vanderbilt_Teacher_Scale.pdf

For youngsters presenting primarily with deficits in attention and behavior regulation, mood swings, social aggression, anger outbursts, and rebelliousness complete the SNAP-IV.

SNAP-IV_Parent&Teacher.pdf

For youngsters presenting primarily with depression and/or anxiety, complete the Johns Hopkins Depression Checklist, NIMH Depression Scale and/or Screen for Child Anxiety Related Disorders.

Hopkins_Depression_Checklist_for_Children.pdf
NIMH_Depression_Scale-Children.pdf
SCARED-Parent.pdf
SCARED-Children.pdf

For youngsters presenting with problems related to substance abuse, complete the POSIT for Parent and POSIT for Teen questionnaires.

POSIT_for_Parent.pdf
POSIT_for_Teen.pdf

For minors and adults presenting primarily with social-communication difficulties, complete the Australian Scale for Asperger or the Autism Quotient Test, respectively.

Australian_Scale_for_Asperger.pdf
Autism_Quotient_Test.pdf

For youngsters 18 YO and adults presenting primarily with mood swings and depression, complete the Mood Disorder Questionnaire and Goldberg's Bipolar Screening Scale.

Mood_Disorder_Questionnaire.pdf
Mood_Disorder_Questionnaire__spanish.pdf
Goldberg's_bipolar_screening_scale.pdf

For youngsters 18 YO and adults presenting primarily with persistent depression, complete the Zung's Depression Scale or Major Depression Inventory.

Zung_Depression_Scale.pdf
Major_Depression_Inventory.pdf
Major_Depression_Inventory__Spanish.pdf

For youngsters 18 YO and adults presenting primarily with problems related to anxiety, complete the Zung's Anxiety Scale or Sheehan Anxiety Scale, Liebowitz's Social Anxiety Scale and/or Social Phobia Inventory.

Zung_Anxiety_Scale.pdf

For adults presenting with attention deficit and behavioral difficulties, complete the ADHD Wender Utah Scale, ADHD Self Rating Scale and have your spouse/partner or parent complete the Adult ADHD-Observer Checklist.

Adult_ADHD_Wender_Utah.pdf
Adult_ADHD_Self_Rating.pdf
Adult_ADHD-Observer.pdf

SCHOOL MEDICATION AUTHORIZATION:

The Alabama State Department of Education requires that all minors receiving medication in school have a signed prescriber/parent authorization in file.

School_Medication_Form_2019.pdf

AUTHORIZATION FOR RELEASE OF INFORMATION:

To authorize the release or exchange of personal health information between your doctors, clinicians, and other parties, complete and sign the Release of Information Form.

Release_of_information.pdf

MONITORING FORMS:

Bipolar_Spectrum_Diagnostic_Scale.pdf
ChildManiaRatingScale_Parent_Version.pdf
Goldberg's_depression_scale.pdf
Goldberg's_mania_scale.pdf
POSIT_Follow_up.pdf
Vanderbilt_Parent_Follow-up.pdf
Vanderbilt_Teacher_Follow-up.pdf
YMRS-Parent_version.pdf

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