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Forms and Tests to Download
 

When making a new appointment, you will need to print two documents and download a third.

The two documents to complete include:walkway

  • personal information form appropriate for the age of the patient/examinee and nature of the service, and
  • the signature page from our Office Policies and Informed Consent. 

Any forms can be provided to you once reaching the office, so come about 15 minutes before your scheduled appointment if you would rather do them by hand. 

If you wish to save some time, follow the steps below:

Step 1:  
From the list below, please select the personal information form best suited to your needs.  Complete the form on-line, print it before exiting, and bring this with you to your first appointment. 

Step 2: 
HIPAA regulations and good common sense require you to review information regarding our office policies, informed consent, and how your health care record is managed.  Print and sign the final page of the Office Policies form.  We need a copy of the signed last page for your file.  Your signature just means you were given and read the form.  It does not mean you are signing anything away or even that you agree with the material. 

Step 3: 
Go to the Biography page of the clinician you are seeing.  There you will find any specific documents your clinician wants you to review before coming to see them.

Informational Documents and Important Forms

There may be certain documents and forms relevant to the reason for your visit.  Your clinician or the office staff may instruct you to view these before the appointment.  Feel free to select from the options below:

Additional Tests and Rating Forms

Your clinician may direct you to this page to complete and print various rating forms to help diagnosis and track your progress.

  • Center for Epidemiological Studies - Mood Scale (At the direction of your clinician, use this simple mood rating form to track progress in your mood over time.  Print the form and bring in to your next appointment.  Scoring and interpretation will be made by a CFMAL clinician.)
  • ADHD Parent Report Forms (Use these forms to rate a child below age 18 regarding symptoms of inattention, hyperactivity, and aggression.  Scoring and interpretation will be made by a CFMAL clinician.)
  • ADHD Retrospective Parent Report (This form is for the parents of adults referred for ADHD evaluation.  Scoring and interpretation will be made by a CFMAL clinician.)
  • Behavior and Learning Report - Teacher Version (Teachers can complete, print, and fax or mail back this rating form to help assess symptoms of inattention, hyperactivity, and compliance in the classroom.  This form is for boys and girls between the ages of 5 and 18.  It will help in diagnosis and tracking treatment efforts.)

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