Quick Guides & Forms
Office Information and Quick References
Triage advice during regular business hours is available to our patients. There is no charge for triage advice during regular business hours.
There is a $8.00 charge for all after hour's calls for nurse advice, help lines and poison control information.
For patients paying at time of service, a discounted rate is offered.
Missed Appointments will result in a $30.00 charge.
- Well Check appointments, if you need to cancel or reschedule, please call with 24 hours notice otherwise $30.00 charge may apply.
- Same day appointments, if you need to cancel or reschedule, please call us one hour prior to appointment time, otherwise a $30.00 charge may apply.
Requests for Medical Records
- There is a charge for medical records when records are released to the parent. $10.00 if records are picked up, $15 if records are mailed. Payment should be included with our signed medical release form in order to expedite your request.
To expedite your first appointment, please arrive a few minutes early to complete registration forms so that we have all the necessary information to treat your child. You may also download and print the forms from this website, fill them out ahead of time, and bring them with you to the first appointment.
- Patient Information
- Patient History
- Well Care Policy
- Credit Card Form
- Authorization For Medical Record Release
- Vaccine Policy
- Financial Policy
New Patient Instructions
Please print and fill out the Patient Information, Patient History, Well Care Policy, and Credit Card Form and bring them to the office on your first visit. You can also fax the forms to 480-545-4551.
Please print out these forms and bring completed forms into the office. The first two forms are for the initial assessment, the third form is the follow-up.
- Vanderbilt Assessment - Teacher Informant
- Vanderbilt Assessment - Parent Informant
- Vanderbilt Assessment - Teacher Follow-Up Informant
- Vanderbilt Assessment - Parent Follow-Up Informant
Click here for more information regarding ADHD.