Click on photos for details.

EVALUATION  FORMS

DIRECTIONS For pdf files: Link to file, download, print, and fill in by hand.

Fill out and bring the Intake Form to the first visit.

Also fill out and bring any other relevant questionnaires.

•   Intake Form   (pdf)

•  Food Allergy Questionnaire   (pdf)

•  Chronic Fatigue Questionnaire   (pdf)

•  Autism Treatment Evaluation Checklist  (pdf)

•  In Future:  New Intake Form for Developmental Delays

Forms & questionnaires copyrighted by Dr. Laura Power, 2000 - 2008.