1. Centennial Pediatrics New Patient Registration

New Family Registration Packet - This packet should be completed ONCE per family. Patient Health History - Please complete for EACH child being registered. Medical Records Release TO Centennial Pediatrics of Spokane - Please complete for EACH child being registered.

2. Dr. Sara Streufert New Patient Registration

Behavioral Health - Dr. Sara Streufert: Intake and History - Please complete ahead of your initial intake appointment. Thank you. Behavioral Health - Dr. Sara Streufert: New Patient Registration Packet - Please complete if you are NOT already a patient at Centennial Pediatrics of Spokane.

3. Autism Evaluation Intake and History

Autism Evaluation Intake and History Please complete this prior to your first visit. Thank you.

ADHD: Teacher Follow-Up Form ADHD: Parent Follow-Up Form ADHD: Parent Initial Form ADHD: Teacher Initial Form

5. Mental Health Screenings

<a value="https://irp.cdn-website.com/bb3c6459/files/uploaded/SCAREDAnxietyScreen(parentstocomplete)15569Before.pdf" label="" type="file" href="https://irp.cdn-website.com/bb3c6459/files/uploaded/SCAREDAnxietyScreen(parentstocomplete)15569Before.pdf" file="true" data-runtime-url="https://irp.cdn-website.com/bb3c6459/files/uploaded/SCAREDAnxietyScreen(parentstocomplete)15569Before.pdf" no_space_b="true" no_space_e="true">SCARED Anxiety Screen (parents to complete) <a value="https://irp.cdn-website.com/bb3c6459/files/uploaded/SCAREDAnxietyScreen(childtocomplete)15568Before.pdf" label="" type="file" href="https://irp.cdn-website.com/bb3c6459/files/uploaded/SCAREDAnxietyScreen(childtocomplete)15568Before.pdf" file="true" data-runtime-url="https://irp.cdn-website.com/bb3c6459/files/uploaded/SCAREDAnxietyScreen(childtocomplete)15568Before.pdf" no_space_b="true" no_space_e="true">SCARED Anxiety Screen (child to complete) PHQ-9 Depression Screening GAD-7 Anxiety Screening

6. Well Check Screening Forms - Ages 12 and Up

PHQ-9 To be completed for all check-ups for 12 years old and older. GAD-7 To be completed for all check-ups for 12 years old and older.

Forms

1. Centennial Pediatrics New Patient Registration
New Family Registration Packet - This packet should be completed ONCE per family.
Patient Health History - Please complete for EACH child being registered.
Medical Records Release TO Centennial Pediatrics of Spokane - Please complete for EACH child being registered.
2. Dr. Sara Streufert New Patient Registration
Behavioral Health - Dr. Sara Streufert: Intake and History - Please complete ahead of your initial intake appointment. Thank you.
Behavioral Health - Dr. Sara Streufert: New Patient Registration Packet - Please complete if you are NOT already a patient at Centennial Pediatrics of Spokane.
3. Autism Evaluation Intake and History
Autism Evaluation Intake and History Please complete this prior to your first visit. Thank you.
4. ADHD Evaluations
ADHD: Teacher Follow-Up Form
ADHD: Parent Follow-Up Form
ADHD: Parent Initial Form
ADHD: Teacher Initial Form
5. Mental Health Screenings
SCARED Anxiety Screen (parents to complete)
SCARED Anxiety Screen (child to complete)
PHQ-9 Depression Screening
GAD-7 Anxiety Screening
6. Well Check Screening Forms - Ages 12 and Up
PHQ-9 To be completed for all check-ups for 12 years old and older.
GAD-7 To be completed for all check-ups for 12 years old and older.

Our Location

3010 South Southeast

Boulevard, Suite A

Spokane, WA 99223

Phone: 509-352-3777

Fax: 509-343-3717

Office Hours

Monday – Friday

8am – 5pm

Saturday – Sunday

Closed

Quick Links

HealthyChildren Website

CDC Main Website

Our Location

3010 S. Southeast Boulevard, Suite A

Spokane, WA 99223

Phone: 509-352-3777

Fax: 509-343-3717

Office Hours

Monday – Friday

8am – 5pm

Saturday – Sunday

Closed

Quick Links

HealthyChildren Website

CDC Main Website

Our Location

3010 South Southeast

Boulevard, Suite A

Spokane, WA 99223

Phone: 509-352-3777

Fax: 509-343-3717

Office Hours

Monday – Friday

8am – 5pm

Saturday – Sunday

Closed

Quick Links

HealthyChildren Website

CDC Main Website

509-352-3777

3010 South Southeast Blvd, Suite A, Spokane, WA 99223

509-352-3777

Forms

Forms Library

1. Centennial Pediatrics New Patient Registration

2. Dr. Sara Streufert New Patient Registration

3. Autism Evaluation Intake and History

4. ADHD Evaluations

5. Mental Health Screenings

6. Well Check Screening Forms - Ages 12 and Up

Quick Links

Quick Links

Office Hours

Quick Links