Forms Library
The following forms and screenings are for registered patients. If you have not yet registered your child with our office, please call us at 509-352-3777 to start the registration process and answer a few basic questions. You will then be directed to the appropriate forms to complete.
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Please make sure that you have first contacted our office before starting the registration forms.
New Family Registration- please complete one per family
Patient Health History- please complete one per child
Release of Medical Records to Centennial Pediatrics of Spokane- please complete one per child in order to obtain his/her previous medical records.
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Autism Evaluation Intake and History- Please complete prior to your first appointment. Thank you!