Forms & Intake Packet
Get Started Quickly. Be Seen Within 48–72 Hours.
At MindHealth MD, we’ve streamlined the intake process to make starting care simple, efficient, and stress-free. Whether you’re a patient, a family member, or a discharge coordinator, this page provides everything you need to begin psychiatric care with us—so nothing delays treatment when timing matters most.
Our intake process ensures patients can be seen by a licensed psychiatric provider within 48–72 hours of submission.
What’s Included in the Intake Packet
Each patient intake includes the following core components:
Basic Demographics & Contact Information
So we know how to reach you and schedule your appointment quickly.
Clinical History Questionnaire
Includes past diagnoses, treatment experiences, and current symptoms.
Medication History
Details on current prescriptions, past medications tried, allergies, and known side effects.
Insurance Verification
Allows our team to confirm eligibility and discuss any out-of-pocket costs before your first visit.
Consent to Treat & HIPAA Authorization Forms
Ensures we can provide care safely, legally, and in coordination with other providers if needed.
Preferred Appointment Format
You’ll select virtual or in-person depending on your needs and comfort level.
Who Should Complete the Packet
- New Patients seeking psychiatric evaluation or medication management
- Recently Discharged Patients transitioning from residential, outpatient, or hospital care
- Family Members or guardians completing intake on behalf of an adult loved one
- Referral Partners providing background for a patient being referred
If you’re a provider referring a patient, you’re welcome to send over documentation or notes to help us complete the packet alongside the patient.
Start Today—No More Waiting
You don’t have to go through this alone. Whether you’re struggling with anxiety, depression, trauma, or simply feeling overwhelmed — support is here.
