Registration Forms

Print the appropriate paperwork for your Evaluation. Bring completed forms with you to the appointment.

Student

Student History Form

Symptom Checklist

Release Form

Adult

Adult History Form

Symptom Checklist

Release Form

For concussion or brain injury evaluations, complete the Concussion-Brain Injury Symptom Checklist instead of the standard Symptom Checklist. Complete all other forms for your age group.