If you have questions about a form, need assistance filling it out, or would like to schedule an appointment for services, please call us at 860-437-4550.Asthma Control Test – ages 4-11Asthma Control Test – ages 12+Bright Futures Physical – age 3Bright Futures Physical – age 4Bright Futures Physical – age 5Bright Futures Physical – age 6Bright Futures Physical – ages 7-8Bright Futures Physical – ages 9-10Bright Futures Physical – ages 11-14Bright Futures Physical – ages 15-17Bright Futures Physical – age 18+Child Enrollment / IntakeColumbia Teen (11 years old +) – to be completed by teenColumbia Teen (11 years old +) – to be completed by parentConsent to VaccinationCRAFFT+N QuestionnaireAdult Enrollment / IntakeFlu Vaccine ConsentCOVID-19 ConsentHealth Assessment RecordPHQ-9PSC (Pediatric Symptom Checklist) ParentReview of SystemsSports physical evaluationReturn to Forms
