Patient Forms

 

 

Our clinic uses a state-of-the art electronic medical records where paperwork is scanned and stored electronically. Despite our efforts to reduce paper waste, there are simply some things that need to have pen put to paper. And it’s not much fun sitting in the waiting room (no matter how well it’s decorated!) filling out paperwork before your child can be seen.

In most cases at least one of the forms linked below will be applicable to your child’s visit. By printing them at home and filling them out before you get to your appointment, you’ll make the check-in process quite a bit faster. And when your little tyke isn’t feeling well, the less paperwork you do in our waiting room, the better for both of you! If you have any questions about which forms you may need, pick up the phone and give us a call. We’re glad to help.

The following helpful items are available in pdf format. Download the free Adobe Acrobat Reader HERE if your computer doesn’t have it.

 

 

Click Below to View and Download Forms

NEW PATIENT FORMS
MEDICAL CONSENT FORMS - If you want to authorize someone to give medical consent for your child's previous doctor to Ptarmigan Pediatrics -- or if you want to authorize someone else to given medical consent for your child, the following forms will be useful.
HEALTH ASSESSMENT FORMS -- If your child is sick, filling out the appropriate form ahead of time that most closely matches your child's chief complaint can be a time-saver in the waiting room. Your doctor will use the contents of this form in consultation with you to develop the most appropriate treatment plan for your child, so fill it out thoughtfully and completely.
PRENATAL / WELL BABY / WELL CHILD EXAMS / AGES & STAGES QUESTIONNAIRES
ADD/ADHD & OTHER EVALUATIONS
SCHOOL DISTRICT HEALTH FORMS - The files below are school-specific forms that require a doctor's signature. We have these on file in our office, but if you are coming in for a specific school-related medical examination you can save time by printing the appropriate form below and filling it out before you arrive.