Intake Forms

Intake Forms are to be completed at least 24 hours prior to your initial evaluation time or you will need to reschedule your appointment. You may sign electronically if it is more convenient. Forms can be emailed to sdang.aprn@gmail.com or through the patient portal.

Required forms include:

• Policies and Procedures

• Credit Card Authorization

• Medication History

• Controlled Substance Policy

If you choose to sign a release of information for your previous psychiatric provider, PCP, or therapist, please find the form below.

• Release of Information