Online Forms
Speed up your visit by completing the necessary form(s) below. For your convenience, you can either fill the form(s) out online or download and print the form(s) and bring it with you to your appointment.
New Patient Adult Form - Download & Print | Submit Online
Required for All Patients Over 18 Years of Age
New Patient Youth Functional History Form - Download & Print | Submit Online
Required for All Patients From 5-18 Years of Age
TBI (Traumatic Brain Injury) History Form - Download & Print
HIPAA Authorization Form - Download & Print | Submit Online
30 Point Quality of Life Survey - Download & Print
Should be filled out if the patient has had any history of learning problems such as:
- ADD/ADHD
- Dyslexia
- Special education services
- Reading delays
- Excessive time spent with homework
- Reading ability not consistent with their ability in other areas
- A learning problem requiring the services of tutors in or outside school