Before Your Initial Appointment
Before the initial appointment, the following form(s) need to be filled out:
Complete this form to provide us with your medical history and current needs. This information helps us determine if we can best serve your psychiatric care needs.
Please read, sign, and bring this agreement with you to your first appointment. This document outlines our practice policies and your responsibilities as a patient.
Please read our HIPAA Notice of Privacy Practices to understand how we protect your medical information.
📋 Important Instructions
Please fill out the forms, sign them, and bring them with you for the first appointment.
Once the information has been submitted, we will contact you as soon as we can.
Office Policies
- No appointments can be made without having the above forms completed.
- If you are late for your appointment and did not notify the office, your appointment will be rescheduled at a later time, based on availability.
- We reserve the right to terminate treatment at any time without prior notification.
Appointment Guidelines
📅 Scheduling
All visits are by appointment only. Initial appointments will be scheduled after reviewing your completed intake form.
⏰ Cancellations
24-hour cancellation notice is required. Missed appointments without notice will incur a $50 administrative fee.
📞 Contact
If you need to cancel or reschedule, please call our office at 203-864-5031 as soon as possible.
What to Bring to Your First Appointment
- ✓ Completed and signed Intake Form
- ✓ Completed and signed Patient Treatment Agreement
- ✓ Valid photo identification (driver's license, state ID, or passport)
- ✓ Current insurance card
- ✓ List of current medications (including dosages)
- ✓ Relevant medical records or previous psychiatric evaluations (if available)
- ✓ Payment for copay or appointment fee
Additional Resources
💳 Payment Information
Learn about payment options, accepted insurance plans, and billing policies.
🏥 Insurance Plans
Check if we accept your insurance plan and learn about coverage verification.