Forms & Policies
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For your convenience, we’ve compiled a list of commonly used forms at our office. Some forms can be submitted online, while others must be completed as PDFs and sent to our office via email (info@mailppa.com) or fax (305-936-1022).
Intake & Registration Forms
- 2025-2026 SURF & PEERS Registration Form (SURF & PEERS)
- Child History & Signature Forms*
- Historia Clinica Del Niño O Adolescente*
- Adult History & Signature Forms*
- Historia Clinical Del Adulto*
- Returning Patient Abbreviated Minor Child History & Signature Forms* - Must be completed if minor has not had an appointment in our office within one year.
- Returning Patient Abbreviated Adult History & Signature Forms* - Must be completed if adult has not had an appointment in our office within one year.
- Adult Updated Paperwork & Signatures* - use this form when the patient started at PPA as a minor and is now an adult.
- Developmental Intake & Signature Forms*
- IQ-Gifted Testing Intake Form*
- Family History (Forensic-Legal Services) & Signature Forms* - This paperwork is to be completed when parents are separated/divorced and there is legal involvement.
Office Policies & Permission Forms
- Credit Card Consent
- Autorización de Cobros por Tarjeta de Credito
- Release of Information - This form is needed in order to communicate with other professionals, physicians, teachers, etc.
- Autorización para la Divulgación de Archivos Psicológicos Confidenciales y la Información Médica Protegida - El formulario es necesario para comunicacion con tros profesionales, como medicos, maestros, etc.
- Consent for Treatment
- Consentimiento para Tratamiento
- Minor Pick-up Authorization Form - Please use if someone else outside of parent/caregiver is picking up your child from our office.
- Payment Responsibility & Agreement
- Contrato de Responsabilidad del Paciente para el Pago
- Telehealth Policies & Teletherapy Informed Consent
- Pólizas y Consentimiento Informado para uso de la Telemedicina
*For the Intake and Group Packets, it is best to complete the forms online so we can expedite your paperwork; otherwise, please complete forms 24 hours in advance and email to: info@mailppa.com or fax to (305) 936-1022. If you are unable to complete the forms ahead of time, kindly arrive 15 minutes prior to your appointment to complete paperwork.
*Para el formularios de historial o registración de grupos, es mejor que los complete y los comparta al menos 24 horas antes de su cita inicial por correo electrónico a nuestra oficina por correo electronico: info@mailppa.com o por fax al (305) 936-1022. Esto ayudará al médico a revisar la información antes de reunirse con la familia. Si no puede completar los formularios con anticipación, llegue a su cita con 15 minutos de anticipación para que pueda completar los formularios necesarios.
