New Client Information

Introduction

 

My practice is currently closed to new clients.

I welcome your call to briefly discuss your current struggles and answer questions you may have about medication management with brief supportive therapy. If my practice seems like a good "fit" for your needs, we will schedule an initial appointment and I will request you relay your insurance information to my professional billing service. Commonly, the soonest availability for an intake is approximately two months after our phone consultation. Please note that I typically return calls during my office hours, Tuesdays through Thursdays 9:30 am to 4:30 pm.

Prior to Initial Session

 

After an initial appointment has been scheduled, you will receive an email to begin completing the intake forms within my electronic health record. The PDF versions are available for your review. 

 

New Client Signature Forms

Notice of Privacy Practices

New Client Questionnaire

Release of Information (ROI)

 

Please notify me if you are unable to complete the forms electronically, then arrive at least 35 minutes prior to our appointment to complete the forms. We can address any related questions and/or concerns during our first meeting.

 

It is recommended you contact your insurance provider and/or my professional billing service well before our appointment to verify fees to be collected at time of service. 

Please note that e-mail is not a confidential form of communication as it is not encrypted or secure. Preferred form of communication will be through the electronic health record. Correspondence by email does not constitute a provider-client relationship. 

Initial Session

 

Please bring the following to your initial appointment:

  • Insurance card if I am billing insurance

  • List of medications or actual bottles (including over-the-counter medications, contraception/hormones, vitamin/herbal supplements)

  • Releases of Information (ROI)  with contact information for each person with whom it would be helpful for us coordinate care, such as your therapist, previous psychiatric providers, primary care provider, and/or medical specialist(s)

  • Any psychological or educational formalized testing reports

  • Copayment, coinsurance, deductible, or payment for session in full, as indicated by my professional billing service. I accept card/Square reader, cash, and check. 

Session Duration and Frequency

  • Initial session is typically 120 minutes

  • Medication management appointments with brief supportive therapy for individuals can range from 30-60 minutes, occurring every 3 weeks to 3 months depending on your level of distress/relief and/or if potential medication changes are discussed or implemented.

  • Multiple cancelled appointments even with advanced notice, may subject you to dismissal as a client. 

Medication Refills

It is my standard practice to provide my clients with a sufficient medication supply if you keep scheduled appointments and reschedule promptly. If you are unable to attend an appointment and are running low on your medication, you are responsible for rescheduling with enough time to prevent you from running out of your medication. Medication changes will also be addressed during your appointment. If you are unhappy with your medication dosage please contact me. Unforeseen circumstances may also arise. If you need a refill of your medication, please call your pharmacy at least 5 business days before you will run out and ask that they fax me a refill authorization to (503) 925-4196. As prescription refills are not emergencies, they will be address during my regular office hours. Medication refill requests are restricted to current/active clients with a scheduled follow up appointment. Controlled substances cannot be refilled by phone and will only be rewritten during your next appointment.

Courage isn't having the strength to go on,
it is going on when you don't have the strength.
~Napoleon Bonaparte

© 2016 by Sheryl Moren, PMHNP-BC, LLC