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Patient Forms

Transfer Your Records To Thrive

For parents that wish to transfer their children’s care to Thrive Pediatrics, please download and complete the Records Authorization Form. Once completed, please submit the request form to the office where they are currently being seen.

Review Our Financial Policy

For any questions regarding anything financial, please feel free to call and speak with one of our receptionists or our billing department. Also for your convenience see Thrive’s Financial Policy.

Thrive Pediatrics Finanical Policy

Notice of Privacy HIPAA

To understand how your child’s medical information may be used and disclosed as well as how you can access this information, please review our Notice of Privacy HIPAA policy.

Notice of Privacy Practices HIPAA

Patient Care

Here you will find a list of forms that our practice regularly uses. Review carefully as some of these patient forms apply specifically to patients, some to parents and some to other people involved in your child’s care such as teachers or other health care providers.

M-CHAT

PHQ 9

SCARED Child

SCARED Parent

SWYC 9 Months

SWYC 18 Months

SWYC 24 Months

Vanderbilt – Parent – Initial

Vanderbilt – Parent – Initial – Spanish

Vanderbilt – Parent – Follow Up

Vanderbilt – Parent – Follow Up – Spanish

Vanderbilt – Teacher – Initial

Vanderbilt – Teacher – Initial – Spanish

Vanderbilt – Teacher – Follow Up

Vanderbilt – Teacher – Follow Up – Spanish