Forms
Emotional Support Animal - Verification Form
After initiating the request for a Emotional Support Animal prescription with your provider please have a verification form completed by your pet’s vet.
Release of Information from Changing Minds Psychiatry
This form is for patient’s that want to their medical records released from Changing Minds Psychiatry either verbally or written.
Release of Information to Changing Minds Psychiatry
This form is for patient’s that want their medical records sent to Changing Minds Psychiatry either verbally or written.
Form Completion Fee Letter
This document is for patient’s that are requesting forms to be completed. This document must be completed to initiate a form request.
Papeleo Para Pacientes Nuevos | New Patient Paperwork
Formularios de pacientes | New Patient Paperwork
Consentimiento del paciente para la fotografía de cuadros médicos | Consent to photo
Consentimiento para discutir la informacion del paciente | General Consent to Discuss
Pin de acceso a la historia clinica del | Chart Access Pin Form