Appointment Forms

If you would like to expedite the intake process, please feel free to fill out and print the documents located on the right side of this page before your visit. Otherwise, please come 10 minutes prior to your appointment time so that you can fill out the forms in our office.

For your initial intake appointment, please do not bring your child with you. The initial intake session should  be attended by the adult parent or guardian only.

The following forms should be completed and printed (by you) for your intake appointment with Sheryl K. Pruitt:

  • HIPAA Consent Form
  • Parkaire Intake Form (not Coaching Intake Form – that is only necessary if you have an appointment with Daniel Pruitt)
  • Parkaire Billing Policy
  • Telecommunication Consent Form

If you complete these forms online, they need to be printed and brought in on the day of your appointment. Please do not e-mail them.

 

Policy Regarding Records Review

Please provide us with any previous documentation you would like us to review at least seven business days prior to your first visit. (Copies of neuropsychological assessments, IEP documentation, school records, etc. Please do not send your original copies.)  We cannot guarantee documentation review for paperwork provided less than seven business days prior to your intake appointment. Any documentation provided less than seven days prior to your initial appointment will be read before your second appointment. There will be an applicable fee for the review of any documents that are more than 25 pages in length cumulatively, as this takes a significant amount of time to read/review. You can mail, fax or e-mail reports. If you choose to e-mail them,  please send them to rsheffield@parkaireconsultants.com.