ADDICTION MEDICINE · MENTAL HEALTH · PEDIATRICS

New Patient Forms

Prepare Before Your Appointment

Completing the requested information before your visit can help us spend more of the appointment focused on your questions, history, and treatment goals.

Information You May Be Asked to Prepare

Depending on the type of appointment, the office may request:

  • Contact and demographic information.
  • Insurance information.
  • Current medications and supplements.
  • Allergies.
  • Relevant medical and treatment history.
  • Prior records or laboratory results.
  • Pharmacy information.
  • Parent or guardian information for a minor patient.
  • Consent and office-policy forms.

Protecting Your Information

Do not email completed forms containing sensitive medical or personal information unless the office specifically instructs you to use an approved secure method. Do not upload sensitive records through the general website contact form.

Need Help?

If you are unsure which forms you need, contact the office before your appointment. The team can let you know which forms apply to the type of visit you are scheduling.

FAQs

Complete the forms the office identifies for your appointment type.

The office should provide an approved secure method for records. Do not send sensitive records through the general website form.

Contact the office so an alternative can be arranged when available.