Forms/Documents

We've provided our most frequently requested forms here for your convenience.


  • Medical Release Form (PDF)
    • Please complete this form to have records transferred to us, or if you’d like to request records from us.
  • Consent by Proxy for Non-Urgent Care (PDF)
    • Please print and complete this form if you are unable to attend your child’s appointment and would like to provide permission for another adult to accompany your child.
  • Vanderbilt Parent & Teacher Questionnaires (PDF)
    • If you are concerned that your child may be suffering from ADD or ADHD, please print one Parent Questionnaire and two Teacher Questionnaires. Please visit our ADD & ADHD page for explicit instructions on the use of these forms.