Online Forms & Handouts Telehealth Consent Form Medical Records Request Form Forms Needed for Specific Checkups New Patients CALL FIRST 1 Month 2 Months 4 Months 6 Months 9 Months 12 Months 15 Months 18 Months 2 Years 2 1/2 Years 3 Years 4-7 Years 8-10 Years 11-12 Years 13-18 Years Forms • • • • • • • • • • • • • • • • New Patients CALL FIRST 1 Month 2 Months 4 Months 6 Months 9 Months 12 Months 15 Months 18 Months 2 Years 2 1/2 Years 3 Years 4-7 Years 8-10 Years 11-12 Years 13-18 Years Patient CRAFFT PHQ • New Patients CALL FIRST 1 Month 2 Months 4 Months 6 Months 9 Months 12 Months 15 Months 18 Months 2 Years 2 1/2 Years 3 Years 4-7 Years 8-10 Years 11-12 Years 13-18 Years Sports Form • • New Patients CALL FIRST 1 Month 2 Months 4 Months 6 Months 9 Months 12 Months 15 Months 18 Months 2 Years 2 1/2 Years 3 Years 4-7 Years 8-10 Years 11-12 Years 13-18 Years Other Non-Age Specific Forms Standalone HIPAA Form Forms Needed for Specific Checkups New Patient (Call First) One Month Two Months Four Months Six Months Nine Months 12 Months 15 Months 18 Months 2 Years 2 1/2 Years 3 Years 4-7 Years 8-10 Years 11-12 13-18 13-18 Year-old Patient-Only Form Patient CRAFFT PHQ • Other Forms Medical Records Request Sports Physical Standalone HIPAA Form
