FORMS:

Forms for Intake Appointment:

Attached please find forms that should be completed and returned BEFORE your parent intake appointment with Dr. McGuire.  Forms may be returned via email (info@leahmcguire.com), mail or fax (908-753-8089).  GeniusScan is a free app that will allow you to scan and email forms using your phone if you do not have access to a scanner.

1.  Authorization Form:  Attached please find an authorization form (in Word and PDF formats for your convenience)  This form gives Dr. McGuire consent to speak with others about your child.  You can complete this form to allow Dr. McGuire to release information to others, receive information from others, or release and receive information from others.  For example, you may wish to give Dr. McGuire consent to speak with your child's school, pediatrician, or anyone else who is working closely with your child. A sample authorization form is additionally attached for your reference.  Please use one authorization form per person/organization.  For example, if you would like to provide consent for Dr. McGuire to speak with the school and with the pediatrician then you would complete two separate forms.

Authorization Form (Microsoft Word)

Authorization Form (PDF)

Sample Authorization Form

2.  Intake Evaluation Form:  Attached please find an intake evaluation form (in Word and PDF formats for your convenience).  This provides very helpful details regarding your child's background and current functioning.  You may wish to print and write on this form.  

Intake Evaluation Form (Microsoft Word)

Intake Evaluation Form (PDF)

3.  Telemedicine Informed Consent:  This document allows us to conduct the intake and feedback appointments virtually.

Telemedicine Informed Consent (Microsoft Word)

Telemedicine Informed Consent (PDF)

4.  Other Helpful Documents:  Please email or bring a copy of patient's most recent report card, any previous evaluations (if applicable), and patient's most recent IEP (if applicable).  Please feel free to reach out with any questions / concerns.

Forms for Testing Appointment:

It is recommended that your child dress comfortably for testing appointments and pack snacks / lunch.

 

What to Expect During Testing (Microsoft Word)

What to Expect During Testing (PDF)