Client Forms
Call Dr.Beth
(602) 386-1292
“Looking through your child’s eyes changes everything
“You’re really good and being Dr. Beth”
– 8 year old boy
New Family Paperwork
New client family parents will be asked to complete some forms before our first meeting. These online forms will be sent to you via the secure Simple Practice client portal after you schedule an intake. After you complete them, they will be sent directly to Dr. Onufrak. Please allow 1 hour to answer all the questions.
You will receive an invitation to create a password to log on the client portal. In another email, you’ll be directed to log on to access and complete these forms.
If you have any difficult accessing the client portal or these forms, please email Dr. Onufrak ([email protected]) or call the office line at (602) 386-1292.
To get back to the portal: Just reply again to any email notice from Simple Practice, or bookmark the Simple Practice client portal URL https://beth-onufrak.clientsecure.me
Release of Information (ROI) Forms
A Release of Information form gives parent permission for Dr. Onufrak to communicate with NON-MEDICAL professionals like: teachers, school or daycare staff, school counselors and psychologists, speech therapist, OTs, art therapist, etc. Please complete separate forms for each professional you’d like Dr. Beth to connect with.
Release of Information (ROI) Forms
For MEDICAL professionals you’d like her to connect with, please complete and bring the Medical ROI. This form would be for your child’s pediatrician, naturopathic, chiropractic, or any specialty physicians (allergist, GI) so they and Dr. Onufrak can coordinate care if needed.
Behavioral Observation: ChildSightTools Noticing Form
This is Dr. Onufrak’s behavior observation form. It will help you begin to gather data on your child. The discoveries you make from this form will also launch the process of developing “ChildSight” – the ability to see daily life the way your child does through his or her eyes. Even a few days of gathering “data” can reveal patterns that had not stood out to you before. These forms also “take me to your world,” so to speak!
Print as many copies of this form as you wish to track behaviors of concern. Bring them to the office for your intake session and office visits.