Click the link below to submit the required form(s) for your visit.

Online Forms


If you have misplaced the forms needed to file testing preauthorization with your insurance company, here are additional copies for you to print and complete.

Child ADHD Parent Rating Scale

Child ADHD Teacher Rating Scale

School Assessment Form

Adult ADHD Symptom Checklist

Once the forms are completed, please return them to our office, fax them to our office at (812) 479-5014, or scan and email them to info@luzioassociates.com