Other Forms or Documents You May Want or Need:

ADULT ADHD SELF REPORT SCALE (ASRS-V1.1) SYMPTOM CHECKLIST (pre-diagnosis)

ADHD/ADD PATIENT SELF-REPORT (post diagnosis)

AUTHORIZATION TO OBTAIN OWN RECORDS

AUTHORIZATION TO RELEASE PROTECTION HEALTH INFORMATION TO OTHERS

​CREDIT CARD AUTHORIZATION FORM

MEDICARE OPT OUT AGREEMENT

PATIENT PROVIDER EMAIL AGREEMENT

PATIENT REQUEST FOR RESTRICTION ON PROTECTED HEALTH INFORMATION (PHI) USE & DISCLOSURE

POLICIES AND PROCEDURES

PRIVACY POLICY