Quality, hope, and personal responsibility.

Current Patient Information:

If you need a medication refill, ADHD rating scales for you or your child's teachers, or a release of information form, the links are located below.

As always, we appreciate and welcome your feedback, so feel free to send us an email if there are other items you'd like to see in this section of our website or have suggestions about how we can improve our services or operations.

Providers For Healthy Living:  Current Patient Forms
Locate the form that you need and then click on it to download.

Medication Refill Request Form

Vanderbilt (ADHD) Rating Scales for Parents

Vanderbilt (ADHD) Rating Scales for Teachers

Release of Information Form

Notice of Privacy Practices

Permission to Obtain Medical Treatment Form

Informed Consent for Treatment

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Providing Quality Services For Central Ohio

Questions about treatment plans or insurance coverage? Contact us.

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