The Pediatric Place

CHADIS Questionnaires

CHADIS questionnaires focus on your child’s physical, emotional and behavioral health and are required for certain visits such as:   Well (most ages 1 month to 22 years), Asthma, ADHD, and Concussion. They are designed for you to easily complete before your child’s visit from a computer, tablet or smart phone.

How CHADIS works:  CHADIS will send you a welcome email to create an account 14 days before your appointment. Follow the steps to create an account, or, if you already have an account, you can access the questionnaires through CHADIS or through our Patient Portal.

1. From Patient Portal, log in using you child’s username and password, or, if you don’t know it, you can log in using your  cell phone number. (It needs to be the cell number we have on file.)
2. From the dashboard, click on the orange CHADIS button.
3. Accept the Terms of Use.
4. CHADIS may prompt for additional patient information.
5. Choose Questionnaires and begin taking them.
6. Be sure to click “Send it! I’m done” so we will receive the questionnaires.

If your child is 11 or older, they will need to complete printed questionnaires. You can print the forms here: 11-22 years old Adolescent forms

Complete the questionnaires at least 2 hours before the appointment to give us time to download and review before you see the doctor. If you have problems accessing questionnaires, contact us at 770-640-8119 or arrive 20 minutes early to the appointment so we can help you.

Forms

Complete the forms below that are relevant to your child’s visit. Most can be complete in advance and emailed or faxed.  Email to:   Fax to: 770-988-5553. Or you can drop them off at the office. If you are sending electronic format, we prefer PDF files. (see notes below on creating a PDF).

New Patient Forms

Newborn Forms

18 + years old Consent Forms

11-22 years old Adolescent forms

Meet and Greet or Prenatal Visit

School and Sports Forms

Leaving?

Creating a PDF        If you are using a printer with scanner capabilities, the scanner should have a PDF format. You can scan the completed forms as PDF then email or fax them.    If you don’t have a scanner, you can create a PDF using your smart phone. The phone app will use the camera to generate a PDF that you can email.  For android devices or PC, use Google Drive (add a document using “+” then select Scan). For Apple devices (iOS 11or higher), use Notes (create a new note, then select “+” or camera, then Scan).