New Client Paperwork
New to the practice? Welcome. Start here.
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.
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.
04
Insurance/Payment Info
This form collects insurance information or provides a waiver to sign if you will not be using insurance. A credit card is kept on file for missed appointments, which have a $75 fee.
05
Privacy Policies
Individuals joining the practice as a psychiatry patient need to sign this.