Patient Forms
Printable Office Forms
Prior to your appointment, the forms listed below can be printed for your convenience. Filling them out beforehand will save you time by not having to complete them during your appointment. If you elect not to fill out these forms ahead of time, please arrive 15 minutes prior to your scheduled time. (You may download Adobe Reader for free at www.adobe.com.)
Patient Forms
Arizona Interscholastic Association: Annual Preparticipation Physical Examination Form (PDF)
Alternate Caregiver Consent
Form (PDF)
Policy for Divorced
or Separated Parents (PDF)
Request for Release of Medical Records To All4Kidz Pediatrics (PDF)
New Patient
Forms
Behavioral Health Forms
ADHD Parent Follow-Up
Form (PDF)
ADHD Parent Initial
Form (PDF)
ADHD Teacher Follow-Up
Form (PDF)
ADHD Teacher Initial
Form (PDF)
Well Check Forms
MCHAT (PDF)
SCARED Anxiety Screen (parents to complete) (PDF)
Edinburgh Postnatal Depression Scale
GAD-7 (PDF)
SCARED Anxiety Screen (child to complete) (PDF)
PSC-17 (PDF)
PHQ-9 (Modified for Teens) (PDF)
PHQ-9 (Adult) (PDF)
Ready to Join the All4Kidz Family?
We’re currently welcoming new patients of all ages from newborns to teens. Joining is easy, and we’re here to answer any questions about the process.