Patient Forms

Our clinic uses a state-of-the art electronic medical records where paperwork is scanned and stored electronically. Despite our efforts to reduce paper waste, there are simply some things that need to have pen put to paper. And it’s not much fun sitting in the waiting room (no matter how well it’s decorated!) filling out paperwork before your child can be seen. In most cases at least one of the forms linked below will be applicable to your child’s visit.

By printing them at home and filling them out before you get to your appointment, you’ll make the check-in process quite a bit faster. And when your little tyke isn’t feeling well, the less paperwork you do in our waiting room, the better for both of you!

If you have any questions about which forms you may need, pick up the phone and give us a call. We’re glad to help. The following helpful items are available in pdf format. Download the free Adobe Acrobat Reader HERE if your computer doesn’t have it.

Ages and Stages Questionnaire Online Forms

Share your child’s ASQ results securely and conveniently with your child’s medical provider via a confidential online portal.

Ages and Stages Questionnaires (ASQs) are a key part of your child’s standard well child exams from ages 2 months through 5 years.  We encourage parents to complete and submit these age-appropriate developmental screening questionnaires through the secure link below.  If this is done a few days before your appointment, we can better serve you when you arrive in our clinic!

Click Below to View and Download Forms