Pediatric/Child Intake Form Mercy Autism Clinic 2025

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The document is a Pediatric/Child Intake Form from the Mercy Autism Clinic, designed for children under 5 years of age. It collects comprehensive information about the child's identification, developmental history, health, behavior, and educational background. The form aims to gather insights on parental concerns, medical history, developmental milestones, speech and language skills, social interactions, and any behavioral issues to assist in evaluating the child's needs and planning appropriate interventions.

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Versions	Form popularity	Fillable & printable
2015	4.1 Satisfied (22 Votes)

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