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    • Leslie P. Beal, M.D.
    • Tamika Brierley, M.D.
    • Lynn Czekai, M.D.
    • Amy Garaffa, M.D.
    • Norine Kanter, M.D.
    • Brian A. Lamoureux, M.D.
    • Christine Lamoureux, M.D.
  • Patient Resources
    • Child Development and Health Information
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New Britain Pediatric Group

  • Home
  • About Us
  • Meet the Doctors
  • Patient Resources
  • Contact Us
  • Patient Portal
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Patient Resources

    • Child Development and Health Information
    • Forms
    • Helpful Links

Forms

      Developmental Assessment

    • ADHD Screening Tools
    • Autism Screening Tool
    • Depression Screen

      Health History

    • Adolescent Health History Questionnaire
    • Headache Diary
    • Health Form - 18 years and over
    • Health History Questionaire
    • Past Medical History Form
    • Tuberculosis Risk Assessment

      Office Forms

    • Acknowledgment of Receipt of Notice of Privacy Practices
    • Authorization for Disclosure of Private Health Records
    • Criteria for “Life Threatening Illness” for gas/electric companies
    • Insurance and Payment Policy
    • Patient Information Form

      School, Daycare, and Camp Forms

    • Authorization for EpiPen / Benadryl Administration
    • Authorization for the Administration of Medication by School, Child Care and Youth Camp Personnel
    • Early Childhood Health Assessment Record
    • Health Assessment Record (Blue Form)
    • Youth Camp Health Exam/Record
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Recently Added Resources

  • Let’s Move
  • Mypyramid.gov
  • CCMCKids
  • Breastfeeding Booklet
  • Depression Screen
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  • Patient Resources
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