New Client Paperwork
New to the practice? Welcome. Start here. There is currently a waitlist to join the practice. Please fill out the paperwork below to queue for a spot when space opens.
Click the photo in each section below to download the corresponding form.
Submit paperwork via email to mysticmandala@gmail.com or via the CONTACT box at the bottom of this page.
01
New Patient Intake Form
All the important questions . . . answered by you!
Fill this out for individual psychiatric services.
Click the photo to access the document.
02
Family Consulting Intake Form
Fill this out if you want to join the practice as a family.
Click the photo to access the document.
03
Office Policies + Consent for Treatment
This form describes my specific office policies and terms for our work together. Everyone joining the practice needs to sign this. Click the photo to access.
04
Insurance Waiver/
Payment Info
This form provides a waiver to sign acknowledging that you will not be using insurance. A credit card is kept on file for fees and add-on services. Click the photo to access.
05
Privacy Policies
Individuals joining the practice as a psychiatry patient need to sign this.