Cockerell & McIntosh Pediatrics - an Affilliate of Children''s Mercy
  • About
  • Hours/Locations
  • Patient Info
  • Services
  • Billing and Insurance
  • Careers
  • Events and Classes
  • Documents and Forms
  • Well Visits
  • Dr. McIntosh

Documents and Forms

ADHD
ADHD Parent Assessment
ADHD Teacher Assessment
ADHD Parent Follow-up

ADHD Teacher Follow-up
ADHD Progress Report

ADHD Progress Report (Spanish)

Allergy
Allergy Questionnaire
Allergy Questionnaire (Spanish)
Allergy Symptom Calendar

Autism
Modified Checklist for Autism in Toddlers
Modified Checklist for Autism in Toddlers (Spanish)

Forms
HIPAA Privacy Policy Acceptance Form
Medical Records Release Form
Patient Information Form
Vaccines for Children (VFC)
MSHAA Form (English)
MSHAA Form (Spanish


Policy
Financial Policy
Missed Appointments
Notice of Privacy Practices
Vaccine Policy Statement


  • About
  • Hours/Locations
  • Patient Info
  • Services
  • Billing and Insurance
  • Careers
  • Events and Classes
  • Documents and Forms
  • Well Visits
  • Dr. McIntosh
Cockerell & McIntosh Pediatrics - an Affilliate of Children''s Mercy

Address

1203 SW State Route 7
Blue Springs, MO 64014,

Contact

P. (816) 228-4770 (text or call)
F. (816) 228-1156
Appointments: (816) 655-0102
Billing: (816) 655-0152

  • sitemap

Follow us