Patient Forms
Please click on the appropriate form and fill out the form online. Your form will be automatically submitted to Dr. Atiga’s office.
- New Patient Registration Packet
- M-Chat
- Pediatric Sudden Cardiac Death Risk Assessment Form
- Staying Healthy Assessment 0-6 Months
- Staying Healthy Assessment 7-12 Months
- Staying Healthy Assessment 1-2 Years
- Staying Healthy Assessment 3-4 Years
- Staying Healthy Assessment 5-8 Years
- Staying Healthy Assessment 9-11 Years
- Staying Healthy Assessment 12-17 Years
- Consent toUse Telemedicine
Spanish Forms
- Declaración del Proveedor al Paciente
- Los Directivos Avanzados
- CUESTIONARIO “MANTÉNGASE SALUDABLE” (0-3)
- CUESTIONARIO “MANTÉNGASE SALUDABLE” (4-8)
- CUESTIONARIO “MANTÉNGASE SALUDABLE” (9-11)
- CUESTIONARIO “MANTÉNGASE SALUDABLE” (12-17)
- CUESTIONARIO “MANTÉNGASE SALUDABLE” (18+)
- Consentimiento Para Utilizar La Telemedicina