Please find a list of our forms.  Feel free to drop them off to any of our clinics, or email them to This email address is being protected from spambots. You need JavaScript enabled to view it..  Please keep in mind email is NOT a secure form of communication.  You can also take a picture and text it to 304-599-8000.   Always make sure your Child's name and Date of Birth are on all paperwork. 

 Cardinal Forms

• New Patient Packet
• Release of Information to Cardinal Pediatrics
• Release of Information to Third Parties

Screeners

• ADHD Forms
  • Vanderbilt - Initial Teacher Form
  • Vanderbilt - Initial Parent Form
  • Vanderbilt - Followup Teacher Form
  • Vanderbilt - Followup Parent Form
• Child and Adolescent Trauma Screen (CATS)
  • CATS Patient / Self Report (7-17 years)
  • CATS Caregiver Report (3-6 years)
  • CATS Caregiver Report (7-17 years)

• Colorado Learning Disabilities Screener
  • Colorado Learning Disabilities Screener
    • Screen for children as early as 1st grade
  • Adult Reading History Questionnaire
    • Both parents should fill out as over 50% of learning differences are hereditary
    • Screen while children are in Kindergarten

• Patient Health Questionnaire (PHQ-9)
  • PHQ-9 Depression Screening
• Screen for Child Anxiety Related Disorders (SCARED)
  • SCARED Child Screen
  • SCARED Parent Screen