Karen H. Harum, MD, FAAP

Clinic for Special Children

A comprehensive resource for children with developmental disorders

Patient Registration

In order to schedule a new patient appointment, please download and fill out the following forms then forward them to our office via email, fax, or regular post. Once the completed packet is received, we will contact you to set up the initial evaluation appointment. However, Dr. Harum is unable to take new patient referrals immediately. If an urgent consultation is needed, this can be done by phone consultation only. For less urgent matters, an appointment can be made in the near future. Thank you for your interest.
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Document Library

NameDescription
DocumentAuthorization for DisclosureAuthorization for Disclosure
DocumentDevelopmental QuestionnaireDev. Questionnaire
DocumentFinancial PolicyFinancial Policy
DocumentHIPAA Patient Consent FormHIPAA Patient Consent Form
DocumentHIPPA FormHIPPA Form
DocumentOffice PoliciesOffice Policies
DocumentPatient RegistrationPatient Registration