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What Patients SayThank you from the bottom of our hearts for helping our son Alex. We are so happy to finally have our son back after 8 years of suffering. Alex is doing great thanks to you!
Parents of a 17 year old Tourette's patient |
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If you have already made an appointment to see the doctor, you may print out the patient registration forms below, complete them and bring to your first appointment. You only become a patient once you are seen by the doctor.
Child Patients - English
Children - New Patient Registration
Authorization for Release of Protected Health Information (PHI) (Send this to your other doctors so they may send records to us - or you can pick up your records and bring them on your first visit.)
Child New Patient Q & A (This is for your information)
Digestion + Immunity=Behavior (This is for your information)
Map to Kotsanis Institute
Checklist for Autism (MCHAT) English
Child Patients - Spanish
Checklist for Autism (MCHAT) Spanish
Adult Patients - English
Adult Registration Form
Authorization for Release of Protected Health Information (PHI) (Send this to your other doctors so they may send records to us - or you can pick up your records and bring them on your first visit.)
Authorization to Charge Credit Card
Patients Health Questionnaire
Map to Kotsanis Institute
Digestion Inmunidad Desintoxicacion