PsychNP Wellness Center, LLC
  • Home
  • Services
  • Contact
  • Staff
  • Forms
  • Resources
  • Addiction Treatment
  • TelePsychiatry
  • Trauma Focused Equine Assisted Psychotherapy
  • FAQ
  • COVID Resources
  • Home
  • Services
  • Contact
  • Staff
  • Forms
  • Resources
  • Addiction Treatment
  • TelePsychiatry
  • Trauma Focused Equine Assisted Psychotherapy
  • FAQ
  • COVID Resources
Search by typing & pressing enter

YOUR CART

Forms

Forms

Patient Portal Access now available. Your provider can provide refills, answer questions, and all other inquiries in an efficient manner.
Patient Portal

Below are forms needed for your first appointment. 
​Please print and complete forms prior your initial evaluation to save time. 


Practice Policies
File Size: 158 kb
File Type: pdf
Download File

New Patient Registration Form
File Size: 142 kb
File Type: pdf
Download File

New Patient Intake Form
File Size: 225 kb
File Type: pdf
Download File

Patient Release Form
File Size: 114 kb
File Type: pdf
Download File

Consent for Treatment, Assignment of Benefits and HIPPA Form
File Size: 122 kb
File Type: pdf
Download File

Telehealth Consent Form
File Size: 127 kb
File Type: pdf
Download File

Credit Card Authorization Form
File Size: 162 kb
File Type: pdf
Download File

Powered by Create your own unique website with customizable templates.