Welcome! Please print and complete the forms below that pertain to you and bring to your appointment. Please complete all forms pertinent to your visit with us.


New Patient Registration Form
 (to be completed by all new patients)

Psychiatry:
Adult Psychiatry History Questionnaire (age 18 and older)
Child and Adolescent History Questionnaire (under age 18)

Sleep:
Adult Sleep Questionnaire (Dr. Ekambaram)
Child and Adolescent Sleep Questionnaire (Dr. Ekambaram)

Neuropsychology:
Neuropsychology Adult Questionnaire (age 18 and older; testing patients only)
Neuropsychology Child/Adolescent Questionnaire (under age 18; testing patients only)

Psychology:
Dr. Hawks' Questionnaire (testing patients only)
Dr. Rojas' Intake Questionnaire
 


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Directions and Parking
Request for Medical Records
Notice of Privacy Practices


For questions and further information, please call (405) 271-5251.