Email : info@drcubala.com

DOWNLOADS

In order to download a form, please click the preferred format:

doc – Word file (the file will show up on the bottom of the screen or in your downloads folder)
pdf – pdf file (the file will open in a new tab)
xls – Excel file (the file will show up on the bottom of the screen or in your downloads folder)

Children:

First consultation (for patients who reserved their first consultation before 10.02.2017):
Child questionnaire – download: doc
ATEC test (only for autism spectrum diseases) – download: xls / pdf
Test assignment before first consultation (for patients who reserve first consultation after 10.02.2017):
Children questionnaire – download: doc
Follow-up consultations:
Report – download: doc / pdf
ATEC test (only for autism spectrum diseases) – download: xls / pdf

Adults:

Personal data form – download: doc / pdf
Medical history inspection authorization form – download: doc / pdf
Other files:
Copy of medical history obtainment form – download: doc / pdf
Personal data form (children) – download: doc
Treatment consent form – download: doc / pdf