Forms & Policies
Medication Refill Policy:
When you need a medication refill please call 610-873-5437 opt 5 at least 48 hours before you need it. All ADD/ADHD medications require 5days notice for a refill.
We do not refill medications on weekends or holidays.
Patient receiving long term medications must have a current annual physical and a med check within the past three months.
Thank you for your understanding.
Before your appointment with us, quickly and conveniently access patient forms from our practice.
Complete Patient Forms Online
Please take the time to fill out the appropriate forms for your visit. You can submit them right away and they will be completed prior to your visit. If you do not fill out these forms prior to your visit, it is very important to arrive 15 minutes early to complete all paperwork prior to your visit time.
If you are an established patient and have not completed the forms under “New Patient” in the past 12 months, please take the time to fill them out prior to your appointment to decrease your wait time in the office.
New Patients:
Newborn, 1, 2, 4, 6 Month Visit:
- Health History & Intake Form (If not completed in the last 12 months)
- Edinburgh Post Partum Depression Screen
9 Month Visit:
- Ages and Stages 9 Months Questionnaire
- Health History & Intake Form (If not completed within the last 12 months)
18 & 24 Month Visit:
- Ages and Stages 18 Months Questionnaire (18 months ONLY)
- Health History & Intake Form (If not completed within the last 12 months)
- M-CHAT (18 & 24 months)
30 Month Visit:
- Ages and Stages 30 Month Questionnaire
- Health History & Intake Form (If not completed within the last 12 months)
12 -18 Year Old Visits:
Additional Forms:
- Request to Transfer Out Form
- Request For Past Medical Records
- ADD parent questionnaire
- ADD ONLINE parent questionnaire
- ADD parent questionnaire Teacher Rating Scale
- ADD ONLINE Teacher Rating Scale
