Forms

Adult ADHD Screening

Click here to view, download or print ADHD screener.

If you wish to discuss ADHD with your provider, please fill this form out and bring it to your appointment.

Approved Pregnancy Medications

Click here to view, download or print pregnancy medications.

A comprehensive list of OTC medications approved for use during pregnancy.

Brief Health Screen

Click here to view, download or print brief health screen.

This form is required to be filled out upon establishing care and annually thereafter for all patients 21 and older.

CRAFFT Teen Health Screen

Click here to view, download or print CRAFFT.

This form is required to be filled out annually for any individuals age 12-21

EOCCO PCP Change Form

Click here to view, download or print EOCCO PCP change.

If you have OHP, EOCCO, or Moda Medicaid, please fill out this form if establishing care

Financial Policy

Click here to view, download or print financial policy.

Bring this form filled in to your first visit.

Health History Questionnaire

Click here to view, download or print health history.

Bring this form filled in to your first visit.

Lead Risk Questionnaire

Click here to view, download or print lead risk.

This form should be filled out for all patients between 1-2 years old.

M-CHAT Autism Screening

Click here to view, download or print M-CHAT.

This form should be filled out for all patients between 18-24 months old.

New Patient Brochure

Click here to view, download or print patient brochure.

This borchure contains helpful information for all patients.

New Patient

Click here to view, download or print new patient form.

Bring this form filled in to your first visit.

OSAA Sports Physical Form

Click here to view, download or print sports form.

This form is required to be filled out and signed by the athlete prior to a sports physical.

Patient Demographics

Click here to view, download or print patient demographics.

Bring this form filled in to your first visit.

Postnatal Depression Screening

Click here to view, download or print postnatal depression form.

This form shoud be filled out by mothers of children 6-12 weeks old

Third-Party Records Release

Click here to view, download or print records release.

Fill out this form and present it to another medical provider to have them transfer records to ThriveWell Clinic.