508-477-5306 | 508-477-0297 (Fax)  | ccpediatrics@comcast.net

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Forms & New Patients


  • Behavioral Health Screens (PEDS, MCHAT, PSC, PHQ-9, Behavioral Assessment, SCARED Child and SCARED Parent) are billable to your insurance company.
  • These are completed by the patient or parent and "scored" by the medical provider.
  • Beginning at age 14 your child's doctor will also complete the Crafft behavior screen. There is no form to complete - it is verbal, but it is billable to your insurance company.
  • Behavioral Screening is performed at the recommendation of the State of Massachusetts. If you wish to decline them you must advise us in advance.
  • All other forms are informational only.


  • At ages 6 months or 1 year and 2 years - 10, we recommend Vision Testing (VEP Testing - Diopsys).
  • At age 6 months or 1 year and annually thereafter we recommend Hearing Screening (Otoacoustic Emissions Testing).
  • Please call your insurance company in advance of the visit to confirm if you will have any cost share.
  • These are important tests, but if you have a deductible we want you to have all necessary information before going forward with the testing.

How to Register as a New Patient

  • Complete & return New Patient Forms. Please allow one week to register your child(ren).
  • Once we have received the necessary medical records, we can schedule any needed appointment. If you need a same day sick visit, please call the office. *Please note, if your child(ren) is followed by a specialist, we will need those medical records as well.

Newborns • New Patient Forms • General Forms