LSPG Patient Forms

The following medical forms will open in a new window for easy printing. The forms are in PDF format. If your computer in unable to open the following links, please download Adobe Acrobat Reader.

• Internal Medicine New Patient Form
• Pediatrics New Patient Form
• H & P Form
• Release of Medical Information Form
• Checklist for Autism in Toddlers (CHAT), Children age 18 and 24 months
• HCY Lead Risk Assessment Guide, Children age 1-6 year
• Tuberculosis questionare, Children age 1-5

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