Psychiatric, Health & Wellness


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NEW PATIENT INFORMATION

PREPARING FOR YOUR FIRST VISIT

1. PLAN TIME ACCORDINGLY- Plan to be at our office for approximately one hour for your first visit. The first appointment is the longest due to collecting data, assessment and evaluation of your condition.

2. FAX REFERRAL-Have your therapist, physician or health care provider fax a summary of the reason for your visit (not required however, helpful)

3. COMPLETE FORMS- Complete all necessary forms -see "Required Forms." There are Four (4) forms to electronically sign and submit online and one (1) form to complete and bring with you to your first visit.

4. PAYMENT- Bring credit card or debit card to pay for your visit. Anthem Blue Cross Blue Shield Patients are responsible for paying co-payment. Patients with other insurance pay in full and file their own claim to insurance for reimbursement.

5. CURRENT MEDICATIONS- Bring all medications you currently take  (If you have been on several psychiatric medications in the past and can't remember the names, please obtain a list from your pharmacy and bring with you). 

6. PRIOR RECORDS- Bring copies of recent blood work/labs (within the past 3 months)- you may obtain from your primary care provider/physician.

7. LEGAL GUARDIAN- If the appointment is for a child under the age of 18, the primary parent and/or legal guardian (primary care giver) must accompany the child to all visits unless otherwise specified.

8. PREPARE DIRECTIONS- Prepare your directions for travel to arrive promptly at your first appointment.

9. REVIEW FREQUENTLY ASKED QUESTIONS-Many patients report this is very helpful in answering many of their questions. 

10. Look forward to a relaxed and comfortable visit and be on your way to feeling great again!

CHECKLIST FOR FORMS TO SUBMIT ONLINE:

Late Cancel /No Show Policy

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Fee Schedule _____
HIPAA/Privacy _____
Consent for Treatment _____

 
CHECKLIST FOR FORMS TO BRING WITH YOU TO YOUR FIRST VISIT:

Patient Data/History

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* We realize gathering all information before your first visit requires time and we thank you in advance.  At Psychiatric, Health & Wellness we want to do our best in serving you!

We look forward to meeting you!

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