Psychiatric History Record

To begin the prospective-patient review process, please download and complete your Psychiatric History Record. This information allows us to determine whether our practice is an appropriate fit for your needs before any appointment can be offered.

Psychiatric History Record Preview
Download Psychiatric History Record

Once you have completed your Psychiatric History Record, you may upload it securely through the Contact section of our website using the Secure Upload (HIPAA) portal. This encrypted upload delivers your document directly to our clinical inbox.

Local and Emergency Mental Health Resources