Complete the Psychiatric History Record Form
This is the form found directly below. ⬇️ (We recommend using a desktop computer, not a mobile phone.)
How it works
Swipe through the steps of the new patient review process below.
This is the form found directly below. ⬇️ (We recommend using a desktop computer, not a mobile phone.)
After completing your Psychiatric History Record form, upload it through our secure Spruce portal.
A physician reviews your request to determine whether our practice is an appropriate fit.
If we can responsibly assume care, we contact you with scheduling options for an initial in-person evaluation. This usually occurs within 48 operating hours after we receive your submission.
Step 1 · The intake form
To begin the prospective-patient review process, please complete your Psychiatric History Record. You can either complete it here in the guided wizard or use the blank PDF option below.
Recommended
This page guides you through the form one section at a time and creates a finalized, non-editable PDF at the end.
Alternative
If you prefer, or if you are on a shared/public device, you may download the blank PDF and complete it separately before uploading it through Spruce.
Privacy reminder: The wizard saves your answers, encrypted with a passphrase you choose, in this browser on this device so you can finish later. The saved copy is deleted when you finish, when you delete it, or 7 days after your last change. On a shared or public computer, please use the blank PDF instead.
Most people take about 45 minutes to complete all 10 pages.
Your filename:
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Important: Do NOT use the back button or refresh this browser tab. Keep this tab OPEN until your secure upload is complete.
After your upload is successfully sent, we recommend that you delete the downloaded PDF from your device's Downloads folder, empty your device's trash/recycle bin (or equivalent), and then close this browser tab/window for your privacy.
This view shows each page of the printed form as a picture, with the answer boxes laid over it, so the questions themselves are not read aloud. If you use a screen reader, choose Guided sections under "How would you like to fill this out?" above. That view asks every question as a labelled field.
Boxes with a green outline are required.