Helping families thrive

POLICIES / FORMS

Practice Policies and Forms

Most PANS practice consents and agreements are signed electronically. Current versions of important policies and forms are available here or in hard-copy at the office.

POLICIES

Financial Policy (as of January 2025)

Annual Administrative Fee (as of August 2026)

ADMINISTRATIVE FORMS

Over 18 Consent for sharing information with guardian(s)

Psychoactive Medication Treatment Agreement under age 18

Psychoactive Medication Treatment Agreement over age 18

Release for communication with behavioral healthcare provider

New Patients: Request for Records from previous provider

Existing Patients: Request for Records from PANS to new provider

CLINICAL FORMS

Vanderbilt Assessment Forms for Teachers: Teacher Informant - Initial Teacher Informant - Follow up