Forms for New Clients
Thank you for trusting Family Psychiatry Practice & Associates with you and your family’s mental health care needs! Before we get started, we do require new patients to fill out some necessary paperwork. These forms provide information to the patient about our practice as well as help us get to know you a little before we see you in the office.
Please use the below links to download or print the required new patient consent and history forms. You may submit these documents* via fax (919-233-4168) or you may utilize the encrypted “upload document” link located in the new patient email sent to you from our Reception Team. If you have yet to receive this email, please reach out to our office at: frontdesk@fppa.com.
New Patient Information Intake Form
In-Person Appointment Consent Form
Release of Patient Information Consent Form
Credit Card on File Consent Form
Financial Policy Agreement Form
Patient Health Questionnaire and General Anxiety Disorder (PHQ-9 and GAD-7)
Adult ADHD Self Reporting Tool
If you are having difficulty accessing or sending the forms to our office, please don’t hesitate to reach out to our staff at (919) 233-4131 and we would be happy to help you in anyway possible!
*New patient paperwork must be received no later than three business days prior to your first appointment. Failure to complete paperwork may result in a delay or cancellation of your appointment. All patient consent forms require a “wet signature”, we cannot accept electronic signatures on forms at this time.