Dr. Turley uses evidenced-based practices whenever possible. Accordingly, he may require various respondents to provide specific information prior to evaluation and periodically as treatment progresses.
See tabs to the left for each form
Time to complete
Use of information
Parent or guardian (all practices)
Dr. Turley requires this information prior to the first evaluation appointment. The form is a comprehensive screening and triage instrument. If detailed information is available in advance of the first visit, that time can be spent on more detailed assessment and treatment planning. Otherwise, the first session must be spent gathering routine data and initiation of care will be delayed.
Parent, guardian, clinician, patient, educator, or any other informed person
This form is required prior to every follow-up visit or when a respondent wishes to request a change in treatment. Information allows Dr. Turley to measure baseline frequency and severity of 30 screening symptoms and to measure responses to intervention.
Educators with information about school functioning
This instrument is provided as a public service by Vanderbilt University. It is used to screen for ADHD, conduct problems, depression, and anxiety. Dr. Turley uses the Vanderbilt to measure outcomes and to adjust treatment.
Brockton Public Schools adjustment Counselors or administrators
Brockton Clinical Consultation Team requires this screening form (download MSWord document) prior to scheduling of a presentation to the CCT meeting. Submit as an email attachment to Vincent Cerce at email@example.com
Educators requesting a school-funded psychiatric evaluation
This information is essential for determining specific consultation questions, screening, and determining the current level of academic functioning. Dr. Turley requires this information prior to scheduling consultation appointments.
Periodically, Dr. Turley posts forms to request feedback for continuous quality improvement. Alternatively, constructive feedback is always welcome at doctor@JeffTurley.com