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Need a form?

Please feel free to download any of these forms that you may need.  When you send us forms that need our signatures or exams, please make sure to fill out all information that you have access to.  This includes your child's name, date of birth, allergies, and any other demographics including our address, phone number, etc.  We do not charge for forms, and generally turn them around within 24 hours.  In return, we ask that you are up to date on your well visits, payments, and that you fill in as much as possible before you send them to us.  For sports and school physicals, you do not need to send us a form.  We have them preprinted with our demographics, just send us a message through the portal and we will return it to you.  We date them the day you ask for them and your well visit is good for 1 year, so if you ask for a sports form anytime while your well visit is still current, we will fill out the form for you without you needing an additional appointment!

Headstart and Preschool Forms

These are often required by daycares.  Please do not worry about the immunization page.  No one in 20 years has had written out all those dates, we will just print out your shot records and put "see attached" on that page.

Vanderbilt Teacher Forms - ADHD

Please have 2-4 teachers fill these out if you are coming in for an evaluation for struggling in school or ADHD.  Please have the homeroom and core subject teachers fill these out.  When you are done, please submit them through the portal prior to your appointment so we can go over them.  It is important to send all Vanderbilt forms, both teacher and parent, on the same day.  If you send them on different days, we cannot tell when you are done submitting them and it gets very confusing.

Vanderbilt Parent Forms - ADHD

Please have both parents fill these out if you are coming in for an evaluation for struggling in school or ADHD.  If your child doesn't have two parents that are involved with their life on a regular basis, please pick a second adult who has insight into your child's behavior.  We do want Mom and Dad to fill out one form together!  This is not nearly as helpful as when both parents fill one out independently.  Mom, please don't let Dad cheat off of your form!  Children relate differently to each parent, and sometimes that difference can help us with an accurate diagnosis.   When you are done, please submit them through the portal prior to your appointment so we can go over them.  It is important to send all Vanderbilt forms, both teacher and parent, on the same day.  If you send them on different days, we cannot tell when you are done submitting them and it gets very confusing.

Developmental Screenings 

Dr. William J. Fisher MD

If you are interested in enrolling in our practice, please give us a call and better yet, schedule a free appointment to come out and meet us!

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