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First-Visit Forms

Before Your First Visit

Before your child's first visit, download and complete the New Patient Information Packet, all Release and Disclosure forms, and the Vanderbilt Initial Assessment for Parents. In addition, be sure to make copies of any previous neurologic evaluations, MRI’s of the brain, EEG records, list of all neurologic medications the child has ever tried, Child Study Team evaluations, Individualized Educational Program (IEP)’s, and any recent report cards. Be sure to bring these copies to the first visit and hand them to the secretary when you register for the visit.

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Of course, also be sure to bring photo identification (such as a driver’s license) and the child’s health insurance card.

 

If the adult bringing the child to the visit is not the legal guardian, a signed letter from the parent permitting this adult to bring the child is required.

If your child is being seen for school problems, learning difficulties, ADHD, or as part of a Child Study Team evaluation, please have at least one (and ideally at least three) of the child's teachers complete the Vanderbilt Initial Teacher Assessment, located down below:
Initial Vanderbilt Assessment for Teachers
New Patient Information Packet
HIPAA Release Form
Photo Release Form
New Patient Financial Agreement
Insurance Disclosure
Initial Vanderbilt Assessment for Parents and Guardians
Adult Vanderbilt Assessment for Patients

Forms

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