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IF you are a new patient, please fill out New Patient Packet, Authorization of Treatment,  PHQ-9, HIPPA, and Pharmacy Information

New Patient Packet

Please complete "New Patient Packet". Remember to press "Submit" at the end. If you exit the page, you will have to start over. All new patients will need to complete.

Authorization of Treatment

We want to be able to treat you, please complete "Authorization to Treatment" form so we can start services. Remember to press "Submit" at the end. If you exit the page, you will have to start over. All new patients will need to complete.

Release of Records

Pharmacy Information

 Please provide your pharmacy information. Remember to press "Submit" at the end. If you exit the page, you will have to start over. All new patients will need to complete.

PHQ-9

Patient Health Questionnaire- 9. Please complete "PHQ-9" form so we can start services. Remember to press "Submit" at the end. If you exit the page, you will have to start over. All new patients will need to complete.

HIPPA

Your info is safe with us! Please fill out the "HIPPA", forms so we can protect you! Remember to press "Submit" at the end. If you exit the page, you will have to start over. All new patients will need to complete.

Release of Records

Who would you like us to share your information with? Please print and fill out the "Records Release Form" so we can help you wholeheartedly with other providers or request information from your other physicians and facilities. 

Adult ADHD Self Report Scale

Unable to focus? Research suggests that the symptoms of ADHD can persist into adulthood, having a significant impact on the relationships, careers, and even the personal safety of your patients who may suffer from it. Remember to press "Submit" at the end. If you exit the page, you will have to start over. 

GAD-7

Feeling Anxious?  Self-administered patient questionnaire is used as a screening tool and severity measure for generalized anxiety disorder (GAD). Remember to press "Submit" at the end. If you exit the page, you will have to start over. 

Safety Plan

Extra Support! You are not alone! Please completed the following steps. Remember to press "Submit" at the end. If you exit the page, you will have to start over. 

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