School, Daycare, Camp and Sports Forms
To guarantee the fastest completion, please use the link above to submit your form. We cannot accept forms sent via email. Please allow 10 business days for processing. Please review our Forms Policy prior to submitting your request.
If your form requires a tuberculosis test (otherwise known as QuantiFERON gold) your child(ren) will be required to have a blood draw. Your preferred provider will order the lab test for you to complete at your preferred lab. The results will need to be attached for the form to be considered complete. Usually, results of the bloodwork are available in 2-5 days.
Telemedicine Consent
Please read the consent form in advance of your telemedicine appointment. You will be asked at the time of your call to agree to the terms before the appointment can begin.
Transferring Records to Our Practice
Privacy Guidelines & Consents
CCP Developmental Screening Tools
If you choose to fill these out at home, these tools are to be brought into the office where they will be tabulated and scored by a doctor. Alternatively, you can fill them out at your convenience as part of your pre-visit check-in.
- Edinburgh (EPDS)
- Modified Checklist for Autism in Toddlers (MCHAT)
- Survey of Well-Being of Young Children: 12 months (SWYC)
- Survey of Well-Being of Young Children: 24 months (SWYC)
- Pediatric Symptom Checklist (PSC17)
- Patient Health Questionnaire (PHQ9)
- Teen Screen
- Vanderbilt ADHD Diagnostic Caregiver Rating Scale
- Vanderbilt ADHD Diagnostic Teacher Rating Scale
33 Rock Hill Rd
1740 South Street
2365 East York Street