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Mid Coast Medical Group

Mid Coast Pediatrics

Forms & Documents

Please click on any of the areas below to display more information, including links to downloadable forms.

Attention Deficit Disorder/Attention Deficit Hyperactivity Disorder (ADD/ADHD)

When calling to schedule an initial appointment for ADD/ADHD, it is important to know that our providers will initially see your child for an extended (15-minute) visit. Your child must be present at this and all visits.

If your child is an established patient and you have a concern about ADD/ADHD, you may be asked to fill out a Vanderbilt Assessment form, and to have your child’s pediatric medical formsteachers also complete this form.

If you have been given forms to have completed, please be sure to bring the completed Vanderbilt forms to your child’s follow-up visit. The provider will score the forms and review them with you. These forms are extremely helpful in the diagnosis and treatment process.

Anxiety & Depression

If you or your child is concerned that he/she may have anxiety or depression, we recommend you contact our office to schedule an appointment to discuss your concerns with one of our providers. In advance of the appointment, you may print out the appropriate form below, have your child complete it, and bring it with you to the appointment. Alternatively, our provider may ask your child to fill one out when he/she comes in for his/her appointment. Please note that it is best to have the child complete the form. Parents may print another for themselves for completion.

Our providers generally see patients with depression or anxiety every three months.

Autism Screening

The M-CHAT Screening questionnaire should be completed at the 18-month and 24-month Well Child Check appointments. To save time, we recommend that you print out the questionnaire below and complete it at home prior to coming to your child's appointment.

Lead Testing

Toddlers at ages 1 and 2 are more likely to be poisoned by lead. Maine requires all children be tested for lead at 1 and 2 years of age. Talk to your child's doctor about a blood lead test.


Mid Coast Pediatrics


Mid Coast Pediatrics welcomes all pediatric patients.

For more information or to make an appointment, please call (207) 721-8333.