FORMS

As you know, in healthcare, there is a lot of required paperwork. We are including the following forms so that you can more easily download them and fill them out as instructed or requested by our office staff.

INTAKE PAPERWORK FOR NEW PATIENTS

REGISTRATION FORMS –
ALL PATIENTS MUST FILL OUT

ALL patients will need to complete the following forms no matter what services they are requiring before the initial appointment. If the patient is scheduled to see a Therapist and a Psychiatrist, they will need to complete the Patient Policies, Privacy Notice, and Registration only once.

Additionally, patients must submit a copy of ID and the front and back of insurance card with these forms.

For Child and Adolescent appointments, parents or court-ordered guardians are the only individuals allowed to bring in a minor patient and complete the paperwork. The Parent/Legal Guardian must stay in clinic while the child is with the provider.  Legal Guardians MUST have the legal paperwork included in the Registration Packet. 

QUESTIONNAIRES

Every patient will also fill out one or two of our questionnaires depending on what services they need, and if they are younger or older than 18 (adult or child). A medication management questionnaire is needed for psychiatrist services, and/or a therapy questionnaire for seeing a therapist. If the patient is scheduled to see a therapist AND a psychiatrist at APT, they will need to complete both questionnaires (therapy AND medication management).  

OTHER FORMS

Not every patient will fill these forms out, but many do.

Release of Information allows us to share your medical information with other entities, such as providers outside of our clinic, schools, workplace, etc…. we cannot share your medical paperwork with anyone unless we have this form filled out.

Telemedicine, especially in light of the coronavirus, is not only convenient but essential in many cases to avoid spreading the virus. We need this form filled out to be able to treat you via telemedicine. Please contact us if you want to set up an appointment via telemedicine.