Appointments
| To set up a New Patient visit (adults 18+ only) | |
1. Please complete the  New Patient Online Request Form, then call (512) 964-6992 and press Option 1 to schedule an appointment time. |
|
| 2.When your appointment has been scheduled, you will receive our intake forms via DocuSign New Patient PPW/Questionnaires - CTMH to complete before your visit. We prefer spouses of current patients seek help with another provider to avoid any conflict of interest in case of separation. |
|
| 3.Please arrive 40 minutes early to your appointmen tif you were unable to complete the intake forms ahead of time. |
|
| 4.Currently we provide medication management services, not psychotherapy or counseling. |
|
| 5.Prescribing Philosophy Note: We do not prescribe high dose of stimulants or high dose benzodiazepines, and normally not together at any strength. We also do not typically prescribe benzodiazepines to someone taking opiate pain medications such as hydrocodone, etc. Some prescription options for ADHD, Anxiety and Insomnia are controlled substances and may require drug screening(s). |
|
| 6.There is a processing fee of $95 per Disability forms and a $25 fee per FMLA leave forms (initial and any subsequent). |
|
| 7.We are NOT registered/certified to prescribe or recommend medicinal marijuana. Visit HERE for registered providers |
|
 |
|
| Complete Patient Form (9 Forms in 1) | |
| 1.Demographics Form |
|
| 2.Office Policy & Notice of Receipt |
|
| 3.Notice of Privacy Practices |
|
| 4.Acknowledgement of Receipt of Notice of Privacy Practices |
|
| 5.Authorization for Release and Receipt of Information Primarily for Family Members / Personal Reasons |
|
| 6.Controlled Substances Therapy Agreement |
|
| 7.Photo Consent Form |
|
| 8.TD Awareness Screener |
|
| 9.Optional Questionnaires |
|
| 10. Telemedicine Informed Consent | |
 Complete Patient Form Word DOC File Size 2473 KB |
 Complete Patient Form Adobe PDF File Size 3417 KB |
|
|
| Individual Forms | |
|
|
| 1. Demographics Form | 2. Office Policy & Notice of Receipt |
| Demographics Form Word DOC File Size 433 KB |
Office Policy & Notice of Receipt Word DOC File Size 44 KB |
| Demographics Form Adobe PDF File Size 173 KB |
Office Policy & Notice of Receipt Adobe PDF File Size 127 KB |
|
|
| 3. Notice of Privacy Practices | 4. Acknowledgement of Receipt of Notice of Privacy Practices |
| Privacy Practices Word DOC File Size 1170 KB |
Acknowledgement Receipt Word DOC File Size 197 KB |
| Privacy Practices Adobe PDF File Size 250 KB |
Acknowledgement Receipt Adobe PDF File Size 155 KB |
|
|
| 5. Authorization for Release and Receipt of InformationPrimarily for Family Members / Personal Reasons |
6. Controlled Substances Therapy Agreement |
| Authorization Release Word DOC File Size 38 KB |
Controlled Substances Therapy Agreement Word DOC File Size 28 KB |
| Authorization Release Adobe PDF File Size 857 KB |
Controlled Substances Therapy Agreement Adobe PDF File Size 429 KB |
|
|
| 7. Photo Consent Form | 8. TD Awareness Screener |
| Photo Consent Form Word DOC File Size 186 KB |
TD Awareness Screener Word DOCX File Size 336 KB |
| Photo Consent Form Adobe PDF File Size 169 KB |
TD Awareness Screener Adobe PDF File Size 542 KB |
|
|
| 9. Optional Questionnaires | 10. Telemedicine Informed Consent |
| Optional Questionnaires Word DOCX File Size 1787 KB |
Telemedicine Informed Consent Word DOCX File Size 15 KB |
| Optional Questionnaires Adobe PDF File Size 1812 KB |
Telemedicine Informed Consent Adobe PDF File Size 244 KB |
|
|
|
|
 |
|
|
|
|
|
Home | TMS | Appointments | Resources | About Us | Contact / Location / Hours | Make a Payment