Why should you check your mental health benefits BEFORE the first appointment? Click here.

NEW PATIENTS:

           Deposit policy:

                    When we schedule new patient appointment, this is one full hour blocked just for you. Unfortunately, due to the large number of No                     Shows at first appointment, we now request $100 deposit at the time of booking new patient appointment. Deposit is fully refundable,                     if you keep your appointment, or cancel giving us at least 48 hrs notice. 

                     You can call the office with payment information, or you can use credit card authorization form and fax it back to us at 813 464 7682.

          Patient forms:

                    Please print, fill out and bring these form with you to your first appointment with the doctor. If you are not able to print them, please                     arrive at least twenty minutes before your scheduled appointment time.

Please make sure to download the forms to your computer before filling them out. If you enter information from this page into the form, it won't be saved. All signature must be either signed by hand, or digitally signed. Typying in the patient name is not a valid signature.

New Patient Forms - Psychiatry

New Patient Forms  - Counseling

If the patient is a minor, please bring also these forms:

​Vanderbilt ADHD Parent Questionnaire

Vanderbilt ADHD Teacher Questionnaire

Other forms:

Authorization for release of confidential information

Credit Card Authorization Form

Office Policy
Tampa Bay Psychiatric Services, PL

Wesley Chapel - 813 699 4020

           Sarasota -  941 527 0159

Respect
Dignity
Compassion