Release of Information
If you have previously sought treatment for mental health concerns, it's very helpful for me to have access to your previous treatment records. These records help me to more quickly understand your concerns and create a treatment plan. In addition, if you are currently seeing a psychiatrist, doctor or other prescribing professional for medication management, I need to be able to coordinate with that professional in order for us both to give you the highest level of care.
Linked here is my release of information (ROI) form. Please print a copy of this form for each treatment provider you have seen in the past or, most importantly, the person who is currently managing your medication. After you've signed these forms, you can upload them into my patient portal, mail them to me at the address below, or fax them to 785.340.3049.
Linked here is my release of information (ROI) form. Please print a copy of this form for each treatment provider you have seen in the past or, most importantly, the person who is currently managing your medication. After you've signed these forms, you can upload them into my patient portal, mail them to me at the address below, or fax them to 785.340.3049.