Preparing For Your Visit

O n this page you will find a complete list of our patient forms. In an effort to provide the best customer service possible and minimize your wait time in our office, please review this list and bring in the necessary forms already completed.

New Patient Forms

In order to help speed up the process of checking in your child for his/her first visit with us, it will be helpful to print out the following forms at home and complete them prior to your visit with us.

Well Visit Forms

18 month and 2 year check-ups:   The M-CHAT is a screening test for autism that we use at these two visits. Please print this form and bring it with you on the day of your appointment completed.

Modified Checklist for Autism in Toddlers

Sports Physical

Please print and fill out the first page (Part 2 - Medical History, Questions #1 - #40) prior to your visit.

Sports Form

Please print and fill out the first page (Questions #1 - #14) prior to your visit.

Pop Warner

ADD/ADHD Initial Evaluation Forms

If your child has never been diagnosed with ADD or ADHD, please complete the following paperwork prior to your child's first appointment for this evaluation. These questionnaires need to be completed, one by your child's teacher(s), and the other by the parent(s). The more forms that are completed, the more accurate the assessment will be. Please remember to bring all of these forms with you for your visit.

Vanderbilt Initial Assessment - Parent Form                               Vanderbilt de Evalucion - Para Padres

Vanderbilt Initial Assessment - Teacher Form

ADD/ADHD Follow-up Evaluation Forms

For all subsequent ADD / ADHD appointments, a teacher and parent Follow-Up Questionnaire need to be completed and brought with you to the appointment.

Vanderbilt Assessment Follow Up - Parent Form

Vanderbilt Assessment Follow Up - Teacher Form

Depression Screen

We are screening for depression with the Patient Health Questionnaire 9 in all teens from ages 12 and up. Please complete prior to the visit and the screening will be discussed with you by the provider.This form is to be filled out by the CHILD.

PHQ-9                                                                                                        PHQ-9 (Espanol)

Anxiety Screen

We are screening for anxiety with the SCARED forms in children 8 years and older. Please complete them prior to the visit and bring the forms with you to the appointment so that the provider can discuss the screenings with you.

SCARED - Child Form (8 years and older)

SCARED - Parent Form

Behavior Screen

The Pediatric Symptom Checklist is a 17 item screening questionnaire listing a broad range of children's emotional and behavioral problems that reflects parents' impressions of their child's psychosocial functioning. The screen is intended to facilitate the recognition of emotional and behavioral problems so that appropriate interventions can be initiated as early as possible.  This form is to be filled out by the PARENT for all children ages 4 - 11 years old.

PSC17                                                                                                         PSC17 (Espanol)

Our Locations

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Hours of Operation

Our Regular Schedule

Palm Beach Gardens

Monday:

8:30 am-5:00 pm

Tuesday:

8:30 am-5:00 pm

Wednesday:

8:30 am-5:00 pm

Thursday:

8:30 am-5:00 pm

Friday:

8:30 am-5:00 pm

Saturday:

9:00 am-11:30 pm

Gardens Office Only: Notes below

Sunday:

Closed

Jupiter

Monday:

8:30 am-5:00 pm

Tuesday:

8:30 am-5:00 pm

Wednesday:

8:30 am-5:00 pm

Thursday:

8:30 am-5:00 pm

Friday:

8:30 am-5:00 pm

Saturday:

9:00 am-11:30 pm

Gardens Office Only: Notes below

Sunday:

Closed

Palm City

Monday:

8:30 am-5:00 pm

Tuesday:

8:30 am-5:00 pm

Wednesday:

8:30 am-5:00 pm

Thursday:

8:30 am-5:00 pm

Friday:

8:30 am-5:00 pm

Saturday:

9:00 am-11:30 pm

Gardens Office Only: Notes below

Sunday:

Closed

Saturday 9:00 AM - 11:30 AM 

Gardens Office Only

Urgent care only. Phones open at 8:30am for scheduling.
Patients are seen on a first-come, first-served basis.