The Kids Clinic, Whitby, ON
The Kids Clinic
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Forms

We encourage parents and teachers to fill out the applicable forms prior to your first visit.

Please click on the links provided on this page to download the following forms:
For appointments call 905-436-1600
905.683.4440
Appointment Instructions
Parental Agreement Form
Adult Intake Questionnaire, to  be completed prior to Adult Assessments.
Child Intake Questionnaire, to be completed by parents prior to Child Assessment.
Preschool Questionnaire, to be completed by Child's Teacher/Caregiver for children younger than age 6.
School Questionnaire, to be completed by Child's Teacher for children ages 6-17.
SNAP-4 Form, to be completed by parents and/or teachers for follow up visits.