To help you save time and provide accurate and complete information for your visit, we have included a list of forms that you can print and complete at home.

New Patient Forms:

• Information / Intake Packets

ADHD Evaulation Forms:

• ADHD Evaluation Information
• Parent Assessment Form
• Teacher Letter
• Teacher Assessment Form

Existing Patient Forms:

• Review of Systems (to be completed at every visit)
• Demographic Update (to be completed annually)

We have also included the following forms for all of our patients to access should they need to review our HIPAA statement or request medical records for Child Neurology Associates, P.C.

• HIPAA Statement
• Prescription Refill form
• Medical Record Request 

You may fax your medical record request form to us at 404-847-9596. Please allow 7 to 10 business days to receive records. If you have any questions, please feel free to call one of our medical records staff at 404-256-3535 x119.