New Patient registration Forms & Other Forms

image: no show policy No Show Policy English Spanish
image: HIPAA notice of privacy practices HIPAA Notice of
Privacy Practices English Spanish
image: medical release form Medical Records Release English Spanish
image: CHPD Gateway Application CHPD Gateway Application English Spanish
image: NICHQ Vanderbilt Parent-Teacher NICHQ Vanderbilt
Assessment Scale English Spanish
image: Patient and Account Discharge Policy Patient and Account
Discharge Policy English Spanish
image: Vaccination Policy Vaccination Policy English Spanish

ADHD Appointments:

Below are the forms for ADHD appointments. Please complete packet and bring paperwork to the registration office in Suite 100 prior to your child's ADHD appointment.

image: adhd school packet santa maria bonita school district Santa Maria Bonita
School District
ADHD School Packet English Spanish
image: adhd school packet all other school districts All other school districts
ADHD School Packet English Spanish