Our policy is to complete any health forms you give us within a seven day time frame. We do make every effort to give you your health form on the same day if you are here for a well visit that very day.
However, effective May, 2017, a fee of $25.00 will be incurred for any physical forms (i.e. the State Blue Form) we receive from you, other than at a well visit, that need to be completed sooner than our usual 7 day time frame. There is also a $5.00 fee for any form needed for activities outside of school.
- Expectant Parent Questionnaire
- New Patient Information Sheets
- Transfer In Form
- State Blue Form (Connecticut State Department of Education Health Assessment Record)
- School, Child Care and Camp Medication Authorization Form
- Authorization for Shared Medical Information (for 18-year-olds and older)
- Vanderbilt Parent Questionnaire (ADHD)
- Vanderbilt Teacher Questionnaire (ADHD)
- Pediatric Symptom Checklist