New Patient Request Form

Patients are asked to fill out a medical release form to authorize the sharing of their confidential health information with outside providers, family members, or other organizations. This step is essential for coordinating care, consulting with other healthcare professionals, and supporting the patient’s overall treatment plan. The release form ensures that privacy is maintained and that all information is shared in compliance with legal and ethical standards. It enables clinicians to communicate with necessary parties—such as primary care doctors, therapists, insurance companies, or supportive family—so that patients receive the most effective and comprehensive mental health care.