Medical Services Forms
If you have questions about a form, need assistance filling it out, or would like to schedule an appointment for services, please call us at 860-437-4550.
- CFA Medical Clinic Enrollment
- Asthma Control Test-ages 4-11
- Asthma Control Test-age 12 +
- Bright Future Physical-age 6 Months
- Bright Future Physical-age 9 Months
- Bright Future Physical-age 12 Months
- Bright Future Physical-age 15 Months
- Bright Future Physical-age 18 Months
- Bright Future Physical-age 2
- Bright Future Physical-age 2 1/2
- Bright Future Physical-age 3
- Bright Future Physical-age 4
- Bright Future Physical-age 5
- Bright Future Physical-age 6
- Bright Future Physical-age 7-8
- Bright Future Physical-age 9-10
- Bright Future Physical-age 11-14
- Bright Future Physical-age 15-17
- Bright Future Physical-age 18+
- Columbia (Teen)-Parent
- Columbia (Teen)-Patient
- Controlled Substance Contract Agreement
- CRAFFT-N
- Covid-19 Vaccine Consent Form
- Flu Vaccine Consent Form
- M-CHAT-R
- Patient Health Questionnaire (PHQ-9)
- Pediatric Symptom Checklist (PSC)
- Preschool Pediatric Symptom Checklist (PPSC)
- Preparticipation Physical Evaluation History
- Review of Systems
- School-Based Health Center Registration
- School-Based Health Center Registration Annual Update
- School Health Assessment Record
- Trauma History Screen-Child
- Vaccine Consent Form