Dr. Leslie I. Rubin
Developmental Pediatric Specialists
Children's Drawing

Forms

New Patients

We ask that all families please complete the following New Patient forms and questionnaire prior to your first visit. The questionnaire helps give us an understanding of what your concerns are and it also provides us a glimpse into your child's strengths and challenges.

Please either fax these forms to us at (404) 303-7837 or mail them to us prior to your appointment date.

Click on the download button to download a form to your computer.

New Patient Questionnaire

Client Information

Financial Policy

HIPAA Agreement

Notice of Privacy Practices

NEW ADDRESS as of SEPTEMBER 29 2014 : 750 Hammond Drive Building 1 Suite 100 Atlanta, GA 30328

Phone 404-303-7247 or 470- 809-5000 Fax 404-303-7837