Developmental Medicine Center | Requesting a Visit

To request an evaluation, please click on "Request an Appointment" or contact us by phone at 617-355-7025.

Patient Intake Forms available online

We require all new families to fill out Patient Intake Forms in order to be added on to our waiting list. We have now made this process a little bit easier by allowing you to print out the form below or complete the form electronically. Please return completed paperwork via mail, email, or fax to:

  • Mail:
    The Division of Developmental Medicine
    300 Longwood Ave.
    Boston, MA 02115
    Attn: Intake Coordinators
  • Email:
    dmcintake@childrens.harvard.edu
  • Fax:
    617-730-0252 Attn: Intake Coordinators

Below you will find intake packages specialized by age. Please click on the correct form for your child:

Age: 27 months or younger
 
Age: 27 months or younger

 

Age: 28 months 

Age: 5-16 years old

Please note

If it has been longer than two weeks since you submitted your intake forms/questionnaires and you have not received notification that we have received them, please call 617-355-7025 and let us know.

For directions and additional information about our satellite locations, please click here.