Telemedicine Consult Request

Complete the questions below and click "Request Forms" to download the needed forms.


Is this patient coming in for a Follow-up visit or a New Visit for this particular Telemedicine specialty clinic?
[A known patient being seen in a different specialty clinic is considered to be a "new visit"]
New Patient  Established Patient

What clinic do you need? Adult-Psychiatry Adult-Psychology CCHD (Center for Child Health and Development) Child Psychiatry Child Psychology Diet and Nutrition Dr. Sonnenschein Healthy Hawks Pain Management Telehelp

I need Spanish forms, if available. Where forms have not been translated yet, the English version is included.

I cannot read zipped (.zip) files.