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Helpful Forms

New Patient Questionnaire

 

Please select the image of the New Patient Questionnaire to download this interactive form. The form will open in a new window or tab. We kindly ask that you fill out and return the form as instructed by our office, prior to your first scheduled appointment. Thank you and we look forward to assisting you. 

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South Lakeland Office

5424 Strickland Ave

Lakeland, FL 33812

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Lake Wales Office

1 Scenic Central, Suite 102
Lake Wales, FL 33853

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Tel: 863-644-8470

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Child and Family Center

1811 Crystal Lake Dr.
Lakeland, FL 33801

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© 2026 by Psychological Associates of Central Florida

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