Sunil N. Lalla, M.D. PA, Bharti Lalla, M.D. FAAP

Available Forms

CHILDREN Annual depression screening PHQ 9 (Children < 18 years) CHILDREN Registration form Dr Bharti Lalla (New Patient) CHILDREN Sports Physical Form CHILDREN Telemedicine Patient Consent Form (Dr Bharti Lalla Children ONLY) CHILDREN Tuberculosis Questionnaire (Children < 18 years) Consent for Paxlovid Doximity telehealth Instructions Six min WALK zADULT Depression screen and Fall Risk Assessment zADULT Telemedicine Patient Consent Form (Dr Sunil Lalla patients) ADULT Medical History (New Patient) Dr. Sunil Lalla ADULT Sleep History (Dr. Sunil Lalla) ADULT Registration form Dr S Lalla (New Patient)

CHILDREN Annual depression screening PHQ 9 (Children < 18 years)

Bharti Lalla MD PA

First Name *

Last Name *

Date of Birth *

Date of Completion *

New Field17

Little interest or pleasure in doing things *

Feeling down, depressed or hopeless *

Trouble falling or staying asleep or sleeping too much. *

Feeling tired or having little energy. *

Poor appetite or overeating. *

Feeling bad about yourself or that you are a failure or have let yourself or family down. *

Trouble concentration on things such as reading the newspaper or watching TV. *

Moving or speaking so slowly that other people could have noticed. Or the opposite being so fidgety or restless that you have been moving around a lot more than usual. *

Thoughts that you would be better off dead or of hurting yourself in some way. *

* Required field