Sound Mind Psychiatry
After this form has been reviewed by office staff and the selected provider(s) you will be called by a staff member for more information or to discuss next steps. We will do our best to do so within one week, and appreciate your patience. Please note that submission of this form is a screening only, and does not establish a patient provider relationship or guarantee acceptance by one of our providers. If we are unable to take you as a patient at this time, we will be happy to provide a few suggestions of alternate providers in the area. Thank you for your interest in seeing one of the providers in our office.
Please note: Individuals aged 13 and older should answer all questions themselves.
Your information will be encrypted.