Completed forms can be sent as attachments on the AthenaHealth portal, by text (206-203-2509), by Spruce message, or by email to hello@intergalacticpediatrics.com

ADHD Forms

For ADHD evaluations, we need the following forms filled out and returned at least 72 hours prior to the scheduled visit:

  1. Each parent to complete their own Initial Evaluation: Vanderbilt Parent.

  2. A teacher to complete an Initial Evaluation: Vanderbilt Teacher.

  3. Each parent to complete the SCARED questionnaire. If your kiddo is old enough to complete a youth SCARED form with/without your help, that would be great as well.

  4. Copies of any prior evaluations, and any other notes from teachers that might be useful.

Initial ADHD evaluation:

Follow up ADHD evaluations:

Preschool ADHD form (PDF)

Mental Health Forms

Asthma Forms