Phone: (954) 531-0847

Fax: (954) 531-0915

Forms

Please click on the New Patient Form button above; completion of the online form is required to schedule your initial office visit. Once your form has been reviewed we will contact you to determine if a visit to our office is appropriate for your needs and schedule your visit. Please answer all of the questions, do not leave any blank, use not applicable where appropriate. Provide us with as much detail as possible. You will be asked a simple question at the end of the form to insure it’s secure transmission, please use all lower case letters. If parents are divorced but share custody and medical decision making for the child, each parent must complete the online new patient form prior to the first office visit. Completing this form indicates you have read and agreed to our Office Policies and Procedures.

The Assessment Forms listed in the Library on this site, contain questionnaires which may be recommended for the diagnosis and treatment  of your child. However, you do not need to complete any specific form prior to your office visit unless instructed to do so. If you have been asked to complete a specific form, you may download and complete the form(s) and either fax or scan and email the completed forms to the office, or bring them with you to your appointment.If you are bringing prior reports, evaluations, or other materials for our review, you do not need to make copies we will scan them into our electronic health record. Also you may email this information to us if preferred at your own discretion.

For the computer based parent and teacher ADHD assessments click on “Parent Computer Based ADHD Assessment” or “Teacher Computer Based ADHD Assessment” and follow the directions. These assessments are transmitted via email directly to our office.