Dr. F. David Templeman

Please press one of the buttons to download the appropriate PDF questionnaire for your child's age.

 

Once downloaded, you can:

1) Print off and complete the questionnaire by hand then return it to the referring physician. 

2) Click on this link                                   (PDFescape.com) where you can then upload the PDF file, complete it with their free online program, save the completed file back to your computer then e-mail it to the referring physician's office or to my office if they don't have e-mail- in which case, make sure you write down who the referring physician is.