Forms

Below you can find a list of forms and useful screening instruments.

New Patient Packet

This file contains forms needed for your initial consultation. Please read and complete them prior to your visit.

Payment Authorization Form

Use this form for remote payment.

HIPAA Privacy Notes

Our Privacy Policy

HIPAA Authorization for Release of Information

These forms are required for us to release any clinical information.

Office Policy

Although contained in our new patient packet, the office policy is available separately for your convenience. Please read it carefully.

Attention Report (Parents and Teachers)

A brief scale useful in tracking symptoms related to attention and concentration.

Attention Report (Self)

A brief self-assessment scale useful in tracking symptoms related to attention and concentration.

Sleep Monitor

This log helps chart out sleeping patterns and how they may respond to various interventions.

Mood Monitor

A useful log to track mood symptoms over the course of a month.

Disclaimer: The above screening instruments cannot be used to diagnose illness but are intended as screening tools that may help the evaluation process. This information on this site is for information only and is not intended as a substitute for psychiatric treatment or obtaining a thorough evaluation with a trained psychiatrist. Hudson Psychiatric Associates does not endorse, represent or assume responsibility for links to other sites and organizations.

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