Follow up Appointment Form

Once you have scheduled your follow up appointments, please complete the below form before each follow up appointment and bring it with you.

Follow Up Appointment Form (pdf)

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Is your child aged 7 and younger?

If your child is aged 7 years or younger, please complete the below forms (in addition to the forms above) and bring them with you before your first appointment.

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ADD / ADHD Forms

If you suspect your child has symptoms of ADD or ADHD, please complete the following forms (in addition to ALL other relevant forms above) prior to your appointment and bring them with you. If your child is 12+ years old, please complete the "ADHD-RS-IV with Adolescent Prompts" form.


Please also have your child's teacher complete the "Conner's 3rd Ed. Teacher Short Form" prior to your child's first appointment and bring it with you.

Anxiety Forms

 If you suspect your child is struggling with anxiety, please complete the following forms (in addition to ALL other relevant forms above) prior to your appointment and bring them with you.  


If your child is younger than 12 years old, please complete the "SCARED Child Version" Form. 


If your child is 12+ years old, please have them also complete the "Adolescent Response Set" form.

Anxiety Questionnaire (pdf)

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SCARED Child Version [For children younger than 12 years old] (pdf)

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Adolescent Response Set [For Patients Aged 12+] (pdf)

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Depression Forms

  If you suspect your child is struggling with depression, please complete the following form (in addition to ALL other relevant forms above) prior to your appointment and bring it with you.  If your child is 12+ years old, please have them also complete the "Adolescent Response Set" form. 

Mood Questionnaire (pdf)

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Adolescent Response Set [For Patients Aged 12+] (pdf)

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Spectrum / Asperger's Forms

   If you suspect your child may be on the autism spectrum ("the spectrum") or have symptoms of Asperger's, please complete the following forms (in addition to ALL other relevant forms above) prior to your appointment and bring it with you.  

PDD Assessment Scale (pdf)

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High Functioning ASSQ (pdf)

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Bipolar Forms

   If you suspect your child may have bipolar, please complete the following form (in addition to ALL other relevant forms above) prior to your appointment and bring it with you.  If your child is 12+ years old, please have them also complete the "Adolescent Response Set" form. 

CMRS - Parent Version (pdf)

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Adolescent Response Set [For Patients Aged 12+] (pdf)

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