Forms

The following resources are available for our patients:

New Patients

New Patient Forms (Form #30509, Rev. 9/24)
Appointments with the Developmental-Behavioral Center are by referral from a child or adolescent's primary care physician. Doctors can download and fill out this form to refer patients to our Developmental-Behavioral Center.

Patient Information Form (Form #31654, Rev 10/23)
This is the annual paperwork that is needed for demographic purposes. You can fill it out in advance if you prefer and bring to the office if you like.

Adult Patient Information - Regional Practices Form (Form #31957, Rev 10/17)

Consent Forms

Parent/Guardian Consent for Treatment Form

Adult Patient Consent for Treatment Form

Medical Records Release
Download one of these forms to authorize the release of your child's medical records.

• Authorization to Release Records TO another health-care provider FROM the Developmental-Behavioral Center (Form #32638, Rev. 10/24)
• Authorization to Release Records FROM another health care provider TO the Developmental-Behavioral Center (Form #32639, Rev. 10/24)