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I request that several forms be reviewed and completed by the time of your first visit. 

Forms are also available through my Luminello Portal, and can be electronically signed. CLICK HERE to access

 

*If you can't or prefer not to use the portal, please complete and print/sign the underlined intake forms below and bring completed to the first visit: 

ADULTS

CHILDREN/ADOLESCENTS

Privacy form

Consent for Telemedicine

Release of Information Form

Practice Policies

Surprise Billing Form

OTHERS:

Vanderbilt Assessment Forms (for ADHD)

Adult ADHD Self-Rating Scale

Depression Rating Scale

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