Quality, Hope, and Personal Responsibility.
HEALTHCARE PROFESSIONALS - You may refer your patients directly using the "Professional Referral Form" link below.  We will contact your patient to schedule an initial intake appointment.  We will contact you directly if we have questions or need additional information.
PATIENTS/PARENTS - If you or a family member are interested in becoming a patient in our practice, simply submit the "New Patient Registration Form" below and you will be contacted to schedule an initial intake appointment.
CHILD ADHD EVALS - If your child/adolescent is coming for an ADHD evaluation, it is helpful to have all parents/guardians and all teachers complete Vanderbilt Diagnostic Forms and bring them to the initial intake appointment. These forms are found below.
NON-CUSTODIAL OR DIVORCED PARENTS - If you have split custody or need permission from another parent to provide treatment to your child, please have them complete the "Permission to Obtain Medical Treatment Form" below and bring with you to your initial appointment.  Without this form, your child legally cannot be seen by our providers.
New Patient Forms - Locate the form that you need then click on it to access it.
New Patient SELF Registration Form - for patients to refer themselves for services
Professional Referral Form - for medical and mental health professionals to refer patients directly
Child/Adolescent ADHD Vanderbilt Teacher Diagnostic Form
Permission to Obtain Medical Treatment Form
Child/Adolescent ADHD Vanderbilt Parent Diagnostic Form
Informed Consent for Treatment
Notice of Privacy Practices