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Patient Forms

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What to bring to your first visit?

We work hard to ensure that your child receives prompt medical care in a comfortable, child-friendly office setting. To help expedite the first appointment, we ask that you please arrive at least 15 minutes prior to appointment time and complete as much of the registration as possible prior to arrival. Pre-registration via athenahealth portal at https://26871.portal.athenahea... or klara is preferred. Please bring your child's insurance card and copay as well as any information related to your child's medical history if available. If transferring care from another provider/facility, we ask that you complete a release of information to request your child's medical records be provided to SEARK Children's Clinic. We are also happy to offer you the option to download, print and complete our office forms to reduce wait times during your first appointment if unable to complete digital pre-registration.

Below are some commonly used forms and screeners that you may print at your convenience:

Consent to Treat Minor Patient without Parent or Legal Guardian Present

Release of Information TO SEARK Children's Clinic

AAP Allergy and Anaphylaxis Emergency Plan

AAP Refusal to Vaccinate Form

Modified Checklist for Autism in Toddlers (M-CHAT-R) (Autism Screen for Ages 16-30 months)

Patient Health Questionnaire (PHQ-9) (Depression Screen for Ages 11+)