Below is a list of all the forms commonly used at our office, for your convenience. Please note some forms are available for internet submission, however, PDF files must be completed and either emailed or faxed to our office (instructions below).

Intake & Registration Forms

• 2024-2025 Social Groups Registration Form (SURF & PEERS)
• Child History & Signature Forms*
• Adult History & Signature Forms*
• Returning Patient Abbreviated Minor Child Intake & Signature Forms* - Must be completed if minor has not had an appointment in our office within one year.
• Adult Updated Paperwork & Signatures* - use this form when the patient started at PPA as a minor and is now an adult.
• Developmental Intake & Signature Forms*
• IQ-Gifted Testing Intake Form*
• Family History (Forensic-Legal Services) & Signature Forms* - This paperwork is to be completed when parents are seperated/divorced and there is legal involvement.

Office Policies & Permission Forms

• Credit Card Consent
• Release of Information - This form is needed in order to communicate with other professionals, physicians, teachers, etc.
• Minor Pick-up Authorization Form - please use if someone else outside of parent/caregiver is picking up your child from our office.
• Payment Responsibility & Agreement
• Consent for Treatment
• Telehealth Policies & Teletherapy Informed Consent

Forms Available in Spanish

Debajo se encuentra una lista de formularios que usamos frequentemente en nuestra practica:

Nota: Las resgistraciónes de grupos no estan disponibles en este momento.

• Historia Clinica Del Niño O Adolescente*
• Historia Clinical Del Adulto*
• Autorización de Cobros por Tarjeta de Credito
• Autorización para la Divulgación de Archivos Psicológicos Confidenciales y la Información Médica Protegida - El formulario es necesario para comunicacion con tros profesionales, como medicos, maestros, etc.
• Contrato de Responsabilidad del Paciente para el Pago
• Consentimiento para Tratamiento
• Pólizas y Consentimiento Informado para uso de la Telemedicina

*For the Intake and Group Packets, it is best to complete the forms online so we can expedite your paperwork; otherwise, please complete forms 24 hours in advance and email to: info@mailppa.com or fax to (305) 936-1022.  If you are unable to complete the forms ahead of time, kindly arrive 15 minutes prior to your appointment to complete.

*Para el formularios de historial o registración de grupos, es mejor que los complete y los comparta al menos 24 horas antes de su cita inicial por correo electrónico a nuestra oficina por correo electronico: info@mailppa.com o por fax al (305) 936-1022. Esto ayudará al médico a revisar la información antes de reunirse con la familia. Si no puede completar los formularios con anticipación, llegue a su cita con 15 minutos de anticipación para que pueda completar los formularios necesarios.