Appointment Request

Sylacauga: 256.208.0060 | Chelsea: 205.678.1286

Patient Forms

If you’re newly visiting our offices, please use one of the available patient forms below. Existing patients may access the patient portal for more options.

New patients packets

If you’re a new patient preparing for an appointment with us, please click on the new patient form above. You can print this document, fill it out, and you’ll be able to get into to see the doctors more swiftly upon arriving at the doctor’s office.

Release of information

To request patient records, please click on the release of information form below. Complete the form in its entirety, including where the records are coming from and being sent to and a parent/guardian signature, and return it ASAP to ensure that records are transferred in a timely manner.

Vanderbilt adhd assessment-parent

Vanderbilt ADHD assessment packets help our doctors have the most thorough understanding of your concerns and your child or student’s symptoms. Please print, fill out, and bring to the office with you. When evaluating for ADHD we will request that your child take a FDA approved computerized test that measures the core symptoms of ADHD.

Vanderbilt adhd assessment-teacher

Vanderbilt ADHD assessment packets help our doctors have the most thorough understanding of your concerns and your child or student’s symptoms. Please print, fill out, and bring to the office with you. When evaluating for ADHD we will request that your child take a FDA approved computerized test that measures the core symptoms of ADHD.