Thank you for choosing our UCLA Developmental-Behavioral Pediatrics Program. Listed below are the forms and questionnaires that we will ask you to complete before you visit us in the clinic. Please download the forms and please send us the Intake Form as soon as you can, via fax, e-mail or mail can so we can schedule the initial appointment.
Additionally, please send us copies of any developmental-behavioral information about your child, including reports from daycare providers, teachers, therapists or other relevant providers (Teacher/Therapist Questionnaire). These forms ideally should be send before the visit if possible. Please bring the originals to the visit.
Address: Developmental-Behavioral Pediatrics Program
300 Medical Plaza, Suite 3300, Los Angeles, CA 90095
If you are a new patient below 5 years of age:
If you are a new patient 5 years of age and above:
If you have any questions, please do not hesitate to call us at 310-794-1456.