Patient Forms

We are always happy to welcome new families into Pediatrics Plus. If you’re looking for a pediatric practice that cares for your child like their own, you have come to the right place.

Please download and complete the following forms, then bring them with you to your first visit.

• New Patient Forms

Please download, complete, and provide our office with the following forms at the beginning of each new year or at any time you need to update any part of the patient’s information:

• Patient Annual Update Information

Please download and complete the following forms before your Initial ADHD or Follow-up ADHD appointment:

• ADHD/Behavorial Health Medication Guidelines
• ADHD Initial Forms (10 and Under) - Parent and Teacher
• ADHD Follow-Up Forms (10 and Under)
• ADHD Initial Forms (11 and Up) - Parent and Teacher
• ADHD Follow-Up Forms (11 and Up)
• Depression Screening (PHQ-9)
• Anxiety Screening for Child (SCARED)
• Anxiety Screening for Parent (SCARED)

Please download and complete the following forms once your child reaches age 14:

• Adolescent Confidentiality

Please review our policies. If you have any questions, please don’t hesitate to reach out to us. 

• General Office Policies
• Walk-in Policy
• Financial Policy
• Billing and Insurance Policy
• List of Required Charges
• Consent for Treatment
• HIPAA Notice of Privacy Practices
• Zero Tolerance Policy