We are happy to provide our office forms for convenient download on your home computer. Please print and complete the forms below, and bring them with you to your child's appointment. Questions about which forms you need? Please call our office and our courteous staff will assist you in preparing for your child's visit.
The four forms below are required to be completed annually. Once completed, please send to our office via email at [email protected] or by fax 281-485-9469.
- Family Registration Form
- General Consent to Treat Form
- Portal Enrollment Form
- Credit Card Authorization Form
Medical Release Form
18 + Demographic Form:
- Notice of Privacy Practices
- Financial Policy
- Office Policy
- PCMH Patient Brochure
- Code of Conduct
- Divorce/Separation Policy
- Vanderbilt Assessment - Parent (Initial)
- Vanderbilt Assessment - Parent (Follow up)
- Vanderbilt Assessment - Teacher (Initial)
- Vanderbilt Assessment - Teacher (Follow up)
- Easy Pay FAQ's (Credit Card on File)
- Parent Flu Waver Form
- COVID-19 Pfizer EUA
- COVID-19 5-11 yr Pifzer EUA
In order to view or print these forms you will need Adobe Acrobat Reader installed.
Click here to download it.