Limited ADHD Screening Information and Forms
Below is some helpful information regarding your upcoming limited ADHD screening appointment with our office, along with some online forms that must be completed ahead of time. Please note that we offer these limited screenings only in certain pre-approved circumstances, and they are not comprehensive ADHD evaluations.
Limited ADHD Screening Forms:
Please follow the links below to complete ALL 7 online forms. You have also been sent SEVERAL forms to complete in your patient portal (therapyportal.com). Please complete ALL ONLINE FORMS AS SOON AS POSSIBLE - at least 72 hours (3 days) before your scheduled appointment.
Beck Inventories (BAI and BDI)
DASS21
AUDIT Screening Tool
DAST
ASRS
Copeland ADHD Checklist
Coordination of Care Form
Be sure to include the name of your Primary Care Physician or referring doctor on the Coordination of Care form
so that we are able to share your report with them.
Please note that you must complete each JotForm and click ‘submit’ before closing the document for it to be saved. Otherwise your information will be deleted for privacy purposes and you will need to fill out the form from the beginning again. All of this information is important in order for us to provide you with the most productive appointment. Thank you.
Click below to login to your patient portal at the time of your appointment:
Please follow the links below to complete ALL 7 online forms. You have also been sent SEVERAL forms to complete in your patient portal (therapyportal.com). Please complete ALL ONLINE FORMS AS SOON AS POSSIBLE - at least 72 hours (3 days) before your scheduled appointment.
Beck Inventories (BAI and BDI)
DASS21
AUDIT Screening Tool
DAST
ASRS
Copeland ADHD Checklist
Coordination of Care Form
Be sure to include the name of your Primary Care Physician or referring doctor on the Coordination of Care form
so that we are able to share your report with them.
Please note that you must complete each JotForm and click ‘submit’ before closing the document for it to be saved. Otherwise your information will be deleted for privacy purposes and you will need to fill out the form from the beginning again. All of this information is important in order for us to provide you with the most productive appointment. Thank you.
Click below to login to your patient portal at the time of your appointment:
Should you have any questions as you are completing the initial paperwork, please contact us.
We look forward to meeting with you!
We look forward to meeting with you!