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Forms


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Sports and School Forms

ADHD Forms
The Vanderbilt Parent and Teacher Assessment Forms must be filled out and mailed to our office prior to an appointment to discuss if you child may have ADHD.   The Vanderbilt Parent and Teacher Followup forms must be filled out and mailed to our office for any patient diagnosed with ADHD prior to a well check or an ADHD check.  The followup forms should be filled out at least yearly for any patient who has been diagnosed with ADHD

ADHD Treatment Contract

Medications used for the treatment of ADHD are classified as stimulants and are tightly controlled by state and federal law and we are required to check state registers to assess frequency of medication refills and prescribers for ADHD medication. Your understanding and cooperation with the guidelines in this treatment contract are required for your child to receive medication for the treatment of their ADHD the Northern Kentucky Pediatric Group (NKYPG).

Anxiety/Depression Forms
The Scared forms have a questionnaire for both the parent(s) and child to complete.