Psych Associates of MD, LLC & Eating Disorders Program
 
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It is easy to print out the forms and information you need to work with us. You can review and fill them out to bring to your appointment, or you may wait until you arrive and we will provide you with the forms and packets you need.
 
Please click below to find:
 
New Patient Information Packet
 
New Patient Registration Forms
(PLEASE PRINT ALL OF THESE FORMS AND BRING WITH YOU TO THE OFFICE)
  • Click here for all forms. This file includes:
    • Cover letter
    • Patient Intake Form (two pages)
    • Consent for Treatment of a Minor (if under age 16)
    • Medical Information Form (two pages)
    • Authorization to disclose Records to PCP
    • Informed Consent for Treatment
    • Preauthorization of Medications
    • Helpful Hints
 
Additional Forms for Existing Patients
 
Forms Your Doctor or Therapist May Ask You To Complete

 

Two Convenient Locations:
120 Sister Pierre Dr.
Suite 403
Towson, MD 21204
Phone: (410) 823-6408
Fax: (443) 279-0537
Toll Free: 877-456-6408

9520 Berger Road
Suite 203
Columbia, MD 21046
Phone: ( 410) 290-6940
Fax: ( 410) 290- 9763
Toll Free: 866-456-6940

Last Modified on August 11, 2017