Services

Patient Forms

Below are our patient forms.  You may click the link below to fill out the forms electronically which will be directly sent to our office or click the link for the printable intake forms to fax or email to our office.  We will need to receive your forms prior to scheduling an appointment.  

Fax (775-525-3885) 

Email (admin@psychreno.com) 

Electronic Fillable Intake Form

Printable Intake Form

Click individual forms below as needed:

Psychiatric Telemedicine Informed Consent

Informed Consent Stimulants/Modafanil

Informed Consent Benzodiazepines/Sedative Hypnotics

Release of Information TO PWR

Release of Information FROM PWR to another provider 

Credit Card Authorization

Notice of Privacy Practices

1875 Plumas St. Suite 6

Reno, NV  89509

P: 775-525-1095

F: 775-525-3885