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

• Newborn Paperwork (New Patient)
• New Patient Registration Paperwork

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.

• School Entrance Health Form
• VHSL Athletic/Sports Participation Form

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