For your first visit, please bring completed forms to the office.
During the COVID-19 physical isolation period:
Please scan and email your forms to our office manager, Shira: email@example.com
fax them: (347) 767-2204 at least one day prior to your telepsychiatry visit.
Call the office to make other arrangements such as sending them by U.S. Postal Service several days in advance of your visit:
- Intake Form
- Telepsychiatry Consent Form
- Anxiety Rating Scale
- Depression Rating Scale
- Debit-Credit Card Recurrent Authorization Form
- Electronic Release of Information Form