How to Make an Appointment
Obtain a referral from your child's primary care physician (PCP) and a commitment from your PCP to manage follow up care.
Call 520-694-KIDS (5437) to register your child with the CPAE clinic.
Submit the following to us via fax (520-694-4486) or email (CPAE@bannerhealth.com):
- Copy of Insurance Card (front and back)
- Completion of Parent and Child Intake forms attached
- If your child needs help with marking answers or if they need the questions read aloud you may assist them in completion. We would like your child’s responses marked even if you disagree. If you do not feel your child has the ability to complete the forms please indicate at the top of the form when you send the packet back.
- Timeline of significant behaviors, infections, therapy, medication, medical diagnosis, etc. (REQUIRED)
- Results of previous laboratory and imaging studies (MRI, EEG, sleep study, LP, etc.)
- Handwriting Sample (homework assignment)
- If your child has experienced a change in handwriting, please submit a sample of both before and after the change
- School accommodations (an IEP or 504 Plan)
- Results of psychological testing or benchmark state standardized test scores
The clinical team will review the intake form and documentation provided to determine if our program will be beneficial to your child. Once determination is made, our clinical team will reach out to you directly to schedule an appointment.
If it is determined that our program is not the most beneficial next step, we will discuss the decision with you and your Referring or Primary Care Provider.
Here is a Clinc FAQ handout to answer additional questions.
Banner - Diamond Children's Multispecialty Clinic
535 N. Wilmot Rd. Ste 101
Tucson, AZ 85711