Forms

Office Information

Patient Forms

Below you will find forms that are required for some office visits. Our office staff will let you know if any of these are necessary. You may print them, fill them out, and bring them to the visit. This will help your visit run more smoothly.

Medical History Forms

Medical History Form 3 Years and Older
Medical History Form Less than 3 Years Old
General Information Sheet

Well Child Visit Questionnaires

Well child forms are now located on our patient portal. Click below to go to our portal.

Patient Portal

Consent Form

Consent Forms

Medical Consent and Verbal Communications

Behavioral Forms

Initial Parent Vanderbilt Assessment Forms
Follow Up Parent Vanderbilt Assessment Forms
Initial Teacher Vanderbilt Assessment Forms
Follow Up Teacher Vanderbilt Assessment Forms
ADHD Follow Up Appointment Form
ADHD Initial Evaluation Form
Behavior Clinic Initial Evaluation Form
Behavior Clinic Follow Up Appointment Form

Medical Records

If you would like to request that another office send records to Complete Children’s Health please fill out the following form.

Authorization to Get Records Form

If you would like to request that Complete Children’s Health send copies of records please fill out the following form.

Authorization to Release Records Form

If you would like to request your Complete Children’s Health Psychology Records please fill out the following form.

Authorization to Release Psychology Records

In addition, many of your child’s records are found on and/or can be requested through the patient portal.

Patient Portal

Vaccination

Acknowledgement to Vaccinate