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

NEW PATIENT:

There is $100 deposit fee to secure first time appointment. Deposit will be applied towards charges due at the appointment.  If appointment is cancelled with at least 48 hrs notice, deposit will be fully refunded. 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.

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.

New Patient Forms

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
Respect
Dignity
Compassion

TAMPA BAY PSYCHIATRIC SERVICES, PL