Patient Forms
We have forms available online for you to view and print. Completing necessary paperwork prior to your child’s visit helps quicken the check-in process. Please take a minute to complete all applicable areas on the form prior to dropping it off or mailing it to our office.
Forms Packets
Individual Forms
- COVID Vaccine Consent Form, Pfizer EUA
- Telemedicine Consultation Form
- Family History Form (Yearly Update)
- Prenatal Forms
- Authorization for Treatment (In absence of Parents/Guardians)
- HIPAA rev 11/1/2017
- Financial Policy
School & Sports Forms
We will complete most child care, public/private school and college medical forms within three business days. *There is a $10.00 fee for each form requested. Please include this payment with your form(s) to expedite the process.
Additional Forms
- Forms for Dr. Shropshire's Patients - Developmental Pediatrician
- Screening Forms - Vanderbilt ADHD Forms, Scared Patient AKG (Anxiety Related Disorders), M-Chat R/F (Autism), Behavioral Health forms for Therapy, PHQ9 (Depression)
- Medical Records Release
- Specialists Referrals
- Parent Survey
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