Questionnaire and Consent Form

Before your first appointment with Dr. Davenport, please do the following.

1. Download and save the appropriate PDF form.

Parent Questionnaire and Consent Form

College Student/Young Adult Questionnaire and Consent Form (Ages 18 – 24)

Adult Questionnaire and Consent Form (Age 25 and above)

2. Complete the form by hand or on a computer.

• You may print and complete the form by hand.

• You may download, complete, and save these PDF forms using a desktop or laptop computer.

• Please do not complete these PDF forms using a tablet or phone.  These forms are not optimized for use with these devices and we have found that the entered information is not always saved correctly using these devices.

3. Fax or E-mail the completed form before your first appointment.

Contact us for our fax number or email the completed form to  info@drmontedavenport.com

Protected Health Information Release Forms

If you want Dr. Davenport to communicate and/or collaborate with physicians, educators, or other professionals, complete the appropriate Protected Health Information (PHI) release form.

Child and Teen PHI Release Form

Adult PHI Release (Age 18 and above)

Questions?

If you have any questions about these forms, contact us.