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Before televideo meetings, please click on the #1 Combined New Patient Information form, or use the #2 Televideo consent form only (for Dr. Azrin or Dr. Millsaps) if you have already filled out the New Patient Information form.

Please click on the Release to give us a release to contact your referral doctor, other doctors, or any family/friends you would like us to be able to speak to:

#1 Combined New Patient Information, Release of Information, and Televideo consent

#2 Dr.  Azrin Televideo Consent form only
#2 Dr. Millsaps Televideo Consent form only

Release of Information Form Only

AND

Please click here for the forms you will need to complete and bring in for your child's evaluation

If already prescribed, ask your doctor if it is alright to skip a day of stimulant medications.  If they approve, then don’t give stimulant medications to the child (Ritalin, Adderall, Concerta, Metadate, etc.), but bring stimulant medications with you.  We perform part of the evaluation prior to giving stimulants.  Then we will give the medications prior to continuing testing.  Give child breakfast / a good night sleep before the evaluation, and bring snacks/drinks for patient, if possible.  Please bring the bottles for all your child’s current medications or a list of the exact names, daily dosages, and who prescribed them.

 

Please have all teachers fill out the Teacher Report Form (make copies as needed).  All parents/guardians should complete their own Child Behavior Checklist separately.  Please bring all forms to this appointment, completed. 

 

A lunch break will usually be taken at noon, unless testing can finish by 1 pm.  Overall, the testing usually lasts from 5 to 8 hours.  Dr. Azrin will spend time with you and your child getting background information and testing.  Many children need short rest breaks.  Most children find the assessment interesting, fun, and worthwhile.  Testing is often split up over 2-3 days.

 

These assessments are commonly requested for individuals who have attention deficit disorder, learning disability, or who have experienced an accident, illness, seizure, psychological difficulties, stroke, or anything that may change the way their brain works.  The evaluation is designed to assess what changes have occurred or problems children have, and look at what this means to your child’s life.  Here are a few common situations that bring people to a neuropsychologist:

 

·         A child is having difficulty with behavior or schoolwork and teachers have raised the question of a learning disability, attention deficit disorder, processing disorder, or some other developmental disorder.

·         A child begins to notice a problem with forgetfulness after suffering a head injury in an accident.

·         A child is depressed or anxious and their ability to think has become worse.

·         A child has suffered some injury to their brain, and they may now have difficulty functioning in some areas of their lives.

 

Richard L. Azrin, Ph.D., is a Licensed Psychologist and Clinical Neuropsychologist.  A neuropsychologist has specialized training in understanding how our brain works and how it affects our behavior, thinking, and personality. 

 

Dr. Azrin will be assessing specific skills using a wide range of activities.  These skills include concentration, memory, language, & problem solving.  Tests include answering questions, remembering certain information and writing things down.  The neuropsychological assessment does not involve a medical check-up, or a psychiatric assessment. 

 

The results of the tests will usually be explained in a follow-up appointment after the evaluation is completed.  Every effort will be made to help you understand your child’s strength and problem areas, and what they might mean to your child’s life (e.g., school opportunities and day-to-day situations).  This will help you look at ways to get around some of the problem areas, and help plan for the future.  We look forward to meeting with you and your child.  Thank you for your time and effort.

 

Please click here for directions and to see the map to our offices

 
    
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