The following documents are for individuals who have already scheduled an appointment with the Center for Family Psychiatry. If you are interested in becoming a new client, please contact us.
These forms are here to shorten your time during your initial appointment. Please print them and bring the completed forms to your first appointment. If you are unsure of the information presented on these forms, they can be discussed with the doctor/therapist during your appointment.
Consent to Treatment Form - This form is an agreement to participate in treatment, along with also explaining confidentiality and appointment attendance expectations.
Health Assessment Form - This form gives us a general breakdown of your physical health and information regarding your primary care physician.
Billing and Fee Agreement Form - This form is to verify your understanding of our service fees and that you are liable for any fees that are not covered by your insurance.
Alcohol Use Identification Test - This document outlines your alcohol use relating to frequency and volume. Alcohol use can affect your health (both mentally and physically) along with affecting medications so it is important to answer these questions honestly.
Prior Medication Trials Form - This form gives us a listing of any medications you may have taken previously, or may currently be taking.