For New Patients
Information for prospective patients/parents and healthcare professionals is found below.
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HEALTHCARE PROFESSIONALS - You may refer your patients directly using the "Professional Referral Form" link below. We will contact your patient to schedule an initial intake appointment. We will contact you directly if we have questions or need additional information.
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PATIENTS/PARENTS - If you or a family member are interested in becoming a patient in our practice, simply submit the "New Patient Registration Form" below and you will be contacted to schedule an initial intake appointment.
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CHILD ADHD EVALS - If your child/adolescent is coming for an ADHD evaluation, it is helpful to have all parents/guardians and all teachers complete Vanderbilt Diagnostic Forms and bring them to the initial intake appointment. These forms are found below.
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NON-CUSTODIAL OR DIVORCED PARENTS - If you have split custody or need permission from another parent to provide treatment to your child, please have them complete the "Permission to Obtain Medical Treatment Form" below and bring with you to your initial appointment. Without this form, your child legally cannot be seen by our providers.
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EMOTIONAL SUPPORT ANIMALS - It is our policy NOT to provide documentation for emotional support animals. Writing an ESA letter involves assessing whether an ESA would meaningfully help a patient. Our mental health providers are not trained to make this determination. Since we are not trained to assess disability, we cannot certify a client’s claim for disability benefits. Given this lack of training, writing ESA letters is arguably outside of our scope of practice.
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New Patient Forms - Locate the form that you need then click on it to access it.
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PFHL Consent for Online/Virtual Mental Health Treatment
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