Patient Forms

These forms are provided for your convenience and can be completed on-line and submitted to our office prior to your first appointment. For new patient enrollment, we require the New Patient Registration Packet and the Initial Health History Questionnaire to be completed. As a reminder, our office only accepts new patients who are up-to-date on their immunizations and remain on the standard schedule.

   

New Patient Forms

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Practice and developmental forms are sent as "pre-registration" via text/e-mail up to 72 hours prior to your appointment. We ask that you pre-register at least 24 hours in advance to allow time for the provider to prepare for your child's visit. This information is important for your child's visit and failure to complete pre-registration documents may result in rescheduling of your appointment. If you have any questions or do not receive a text or e-mail please contact the office at 785-856-9090. We appreciate your understanding. 

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Please review the following policies: 

HIPAA Privacy Policy

Patient Bill of Rights

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Office Policies

Co-Parenting Policy

   

High School Sports Forms

A fillable form will be text to you up to 72 hours prior to your appointment. If you do not receive a text or have any questions please contact the office. 

   

ADHD / ADD Assessments

 Form Icon    ADHD/ADD Vanderbilt Assessment Form (Parent)
 Form Icon   ADHD/ADD Vanderbilt Assessment Form (Teacher) 
   

Transferring Records Consents 

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Transferring from Our Office

   

Mental Health Questionnaires

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SCARED Parent

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SCARED Youth

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PHQ-9 Questionnaire

 

Lawrence Pediatrics, PA
3310 Clinton Parkway Ct
Lawrence, KS 66047

Phone: 785.856.9090
Fax: 785.856.9093

Our Hours
Monday thru Friday:
8am to 5pm
*Closed from 12:00-1:20
*Phone answered until 4:00 p.m. messages left after that will be returned the next business day

After Hours Information

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