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 Request for Psychiatric Evaluation

Parent or guardian (all practices)

45-60 minutes

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.

Clinical Update

Parent, guardian, clinician, patient, educator, or any other informed person

10 minutes

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. 

Vanderbilt Teacher Scales

Educators with information about school functioning

5 minutes

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 CCT Request

Brockton Public Schools adjustment Counselors or administrators

30-60 minutes

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 vincentcerce@bpsma.org

School Request for Consultation

Educators requesting a school-funded psychiatric evaluation

30-60 minutes

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.

Customer Satisfaction Survey


5 minutes

Periodically, Dr. Turley posts forms to request feedback for continuous quality improvement.  Alternatively, constructive feedback is always welcome at doctor@JeffTurley.com