Forms and Resources


Initial Visit Forms

Office Policies

Notice of Privacy Practices

Credit Card Coverage

Patient Registration Form

Initial Medical Questionnaire

Risk Assessment

Alcohol Screening Questionnaire (AUDIT)

Telepsychiatry Form

Telepsychiatry Consent Form


National Suicide Prevention Lifeline: 1-800-273-8255 or text 747-741

Information on safe disposal of unwanted medications: or

For information on Mental Health:

National Institute of Mental Health

On ADHD Diagnosis

Given the volume of phone calls for ADHD treatment, we would like to inform our potential patients that they should be fully aware of the general procedure followed for making an ADHD diagnosis.

ADHD stands for Attention Deficit/Hyperactivity Disorder. ADHD is a real disorder that affects children, adolescents, and adults. It is classified into three different types: predominately inattention type; predominately hyperactivity/impulsivity type; and the combination of attention and hyperactivity type. The symptoms may appear differently in patients of different ages. However, ADHD symptoms, generally speaking, must appear prior to the age 12 years, and they need to be present in two or more settings such as at home, school, or in the work place. The symptoms cause significant impairment in a person’s functioning. The symptoms have to have persisted for at least 6 months to a degree that is more frequent and severe than in one’s peers. The symptoms are not to be better accounted for from another underlying medical or mental disorder(s).

If you were treated for ADHD by a previous psychiatrist or primary care doctor, you must be willing to sign a medical record authorization release form, so that we can obtain the previous medical records.

If you want to be evaluated by us for ADHD, We have to do a thorough evaluation that includes a initial psychiatric evaluation by our clinicians, and a neuropsychological/psychological testing by a neuropsychologist.

On Emotional Support Animal Letters

Our office has seen an increase in patient requests for emotional support animal letters for the purpose of recognizing a patient’s pet as a “therapy pet” to secure “no pet” housing and/or traveling. We do not provide this service because therapy animals are not legally protected under the Disabilities Act, Fair Housing Act, and Air Carrier Transport Act.

We do sign emotional support animal letters if the pet is a certified service or emotional support animal and if our patient has brought in the appropriate certification document(s).

In other words, we do not have the ability to certify animal as “emotional support animal or service animal”, but we can support an already certified pet.

Our clinic always strives to provide the best and most comprehensive treatment for our patients.

Please call our office at (858) 354-1304 for any questions or to schedule an appointment.