If your request is urgent, please call our office at (855) 436-7792 to request an appointment today.

 

Intake & Registration Information

Adolescent Registration Packet:

  • When filling out demographic information provide the patients info (with the exception of phone numbers and emails addresses)
  • All insurance information must be filled out.
  • 3 emergency contacts (parents are included)
  • Releases mist be filled out and signed for every emergency contact.
  • Release forms must be filled out for anyone you want GenPsych to have communication with. (ex. referral, psychiatrist, therapist, etc.)

Adult Registration Packet:

  • All insurance information must be filled out.
  • 3 emergency contacts (parents are included)
  • Releases must be filled out and signed for every emergency contact.
  • Release forms must be filled out for anyone you want GenPsych to have communication with. (ex. referral, psychiatrist, therapist, etc.)

Adult Intake Packet

Teen Intake Packet