Helpful Forms

Please complete the appropriate forms below before your office visit. This will save you time in the waiting room. You can fax the forms in advance or bring them with you to your visit. Eugene Pediatric Associates accepts all major health insurance plans. Please bring your insurance information at the time of your visit.

ADHD Parent Questionnaire

ADHD Teacher Questionnaire

Adolescent Parent Questionnaire

Adolescent Questionnaire

Authorization to Use/Disclose Health Information

Consent to Seek Treatment for a Minor Child

Depression Questionaire

Medical History

Notice of Privacy Practices

Registration Over 18

Registration Under 18