Forms

Prior to your child’s appointment, you may be asked to complete screening questionnaires. Please fill out and return any requested forms before your child’s visit. Completed forms can be returned by email: kootenaypeds@gmail.com or fax: 1-888-760-8399.

Attention Deficit Hyperactivity Disorder

CADDRA SNAP 26 Teacher-Parent Rating Scale – Fillable
CADDRA Teacher Assessment Form – Fillable
CADDRA Adult ADHD Self Assessment – Fillable
Instructions on how to use the CADDRA fillable forms
  1. Save the form on your laptop or desktop computer
  2. Open up the form, fill it out electronically and remember to save it again after filling it out
  3. You can now attach and return the completed form by email to kootenaypeds@gmail.com

Anxiety / Depression

SCARED Anxiety Screen – Child Version
SCARED Anxiety Screen – Parent Version
Kutcher Adolescent Depression Scale
PHQ-9 Depression Questionnaire
Antidepressant Monitoring Form

Autism Spectrum Disorder

Modified Checklist for Autism in Toddlers
C.A.S.T. Childhood Asperger Syndrome Test
Australian Scale for Asperger’s Syndrome

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