Center for Autism & Related Disabilities
Intake Packet

Directions:

Please enter the password to access the Patient History Questionnaire. Print the questionnaire (it is 15 pages), complete the document, and then mail or hand-deliver the questionnaire with accompanying diagnostic reports to the CARD office. The information that you provide is confidential and will not be shared without your written consent. Also, for confidentiality purposes, do not attempt to complete this document on your computer and send it via email. If you have questions, please contact CARD at (904) 633-0760.

If you do not have the password, please contact the UF/Jacksonville CARD Office at (904) 633-0760.

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