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

Initial evaluation:

• Vanderbilt parent form — fillable PDF

• Vanderbilt teacher form — fillable PDF

Follow up evaluations:

• Vanderbilt parent follow up — fillable PDF

• Vanderbilt teacher follow up — fillable PDF

Preschool form (PDF)

Mental Health Forms

• SCARED form for youth — fillable PDF

• SCARED form for parents -- fillable PDF

• PHQ-9 depression screener -- fillable PDF

• Mood and Feelings Questionnaire

  • Child Self-Report – Short Version

  • Child Self-Report – Long Version
     

  • Parent-Report on Child – Short Version

  • Parent-Report on Child – Long Version

Asthma Forms

• TRACK for kids under 5

• Asthma Control Test for 4—11 year olds

• Asthma Control Test for 12 and up