This form is for authorization for someone other than the parents/guardians to bring the child to an appointment.

This form is mandatory to update patient demographics every year at Well Child Check-Ups or New Patient Appointments. Please also complete if there are changes in insurance or demographics.

This form is the Health Insurance Portability and Accountability Act, a US law designed to provide privacy standards to protect patients' medical records and other health information provided to health plans, doctors, hospitals and other health care providers.

This form is to allow us to receive records from the hospital, specialists or previous doctors.

This form allows patients that are ages 18 or older to give parents and/or guardians access to records and authorization for CMA to provide them with their records.

This form is a mental health screening that is done at all Well Child Check-Ups for ages 12-21.

Este formulario es una evaluación de salud mental que se realiza en todo Examen Físico Anual para edades de 12-21.

This form is a developmental questionnaire for ages 9mo, 18mo, 2yrs, 30mo, & 3yr

Este formulario es un cuestionario para edades 9 meses, 18 meses, 2 años, 30 meses, y 3 años

This form is a developmental questionnaire for ages 18mo, 2yrs, 30mo, & 3yrs.

Este formulario es un cuestionario de desarrollo para edades de 18 meses, 2 años, 30 meses y 3 años.