New Patient Forms

First off, let us say “Thank You” and “Welcome” from all of us here at Alkire Creek Psychiatry. We are very happy that you have decided to make your first appointment with Dr. Weiss, and we look forward to a lasting relationship with you in the future.

New Patient Form Instructions

Please select the appropriate New Patient forms below. You will be filling out 2 forms prior to your first visit. The Adult New Patient Form is for new patients that are 18 years or older, and the Minor New Patient Form is to be filled out for new patients that are under the age of 18.

The New Patient Release of Information is required for all new patients.

•    Adult New Patient Forms
•    Minor New Patient Forms
•    New Patient Release of Information

After you have selected the proper forms, we request that you please print the forms and fill it out as completely as possible.

Once complete, make sure you bring your forms with you on your first visit. That’s it. -Thank you.

Forms are in Adobe Acrobat PDF format. If you have any trouble downloading and printing the forms please visit this site to download Adobe Reader. http://get.adobe.com/reader/