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Patient Forms

If you have scheduled an evaluation, you must complete one of the following forms prior to your visit.

Instructions for completing the questionnaires:

  1. Click the link for the appropriate questionnaire
  2. Download and fill-in the questionnaire
  3. Submit the completed questionnaire by either faxing it to 205-408-9257 or email it to


Child Questionnaire (Ages 18 and Under)

Adult Patient Questionnaire

Sensory Processing Questionnaire

School Age Child Symptom Sheet