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ADMISSION FORMS: 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. 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: 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 UPDATE NAME AND PHONE NUMBER: |
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