B.T.M. Psychiatric NP Services, PLLC

B.T.M. Psychiatric NP Services, PLLCB.T.M. Psychiatric NP Services, PLLCB.T.M. Psychiatric NP Services, PLLC
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B.T.M. Psychiatric NP Services, PLLC

B.T.M. Psychiatric NP Services, PLLCB.T.M. Psychiatric NP Services, PLLCB.T.M. Psychiatric NP Services, PLLC

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filler@godaddy.com

  • Home
  • THE PROVIDERS
  • INSURANCES ACCEPTED
  • SERVICES & FEES
  • THE OFFICE SPACES
  • FORMS
  • CONTACT US

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ADULT WELCOME PACK

 DO NOT fill out any forms unless advised to do so AFTER you have had a consultation.  After the consultation, new clients that are accepted,  will receive a welcome email with instructions.  These forms MUST be completed electronically via the patient portal 48 hours PRIOR to your next visit after the consultation.  

*WELCOME PACK ADULT (pdf)Download
*HIPPA NYS (TO GIVE INFO) (pdf)Download
*HIPPA NYS (TO RECEIVE INFO) (pdf)Download
*PHQ 9 (pdf)Download
*GAD SCALE (pdf)Download
*MOOD DISORDER QUESTIONARE (pdf)Download

CHILD/ADOLESCENT WELCOME PACK

For clients 17 years old or younger, the parent/guardian should complete forms with (*) AFTER the Consultation.   DO NOT fill out any forms unless advised to do so AFTER you have had a consultation.  After the consultation, new clients that are accepted,  will receive a welcome email with instructions.  These forms MUST be completed electronically via the patient portal 48 hours PRIOR to your next visit after the consultation.  

*WELCOME PACKET (CHILD) (pdf)Download
*HIPPA NYS (TO GIVE INFO) (pdf)Download
*HIPPA NYS (TO RECEIVE INFO) (pdf)Download
ADHD PARENT SCALE (pdf)Download
ADHD TEACHER SCALE (pdf)Download
DEPRESSION SCREENING (pdf)Download

MEDICINAL MARIJUANA

This is for APPLICABLE clients ONLY. ALL  forms must be completed and emailed  to bmorrison@btmfamilypsych.com LESS THAN 48 HOURS PRIOR TO APPOINTMENT. If not appointment is subject to cancellation and fees paid are NON-REFUNDABLE. 

MM QUESTIONARE (pdf)Download
BTM MEDICAL MARIJUANA CONSENT (pdf)Download

B.T.M. Psychiatric NP Services, PLLC

6 Gramatan Avenue, SUITE 614, Mount Vernon, New York 10550, United States

OFFICE: 914-214-1162 FAX: 914-243-1970

Copyright © 2017 B.T.M. Psychiatric NP Services, PLLC - All Rights Reserved. 

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ONLY Accepting NEW clients for Medication Management

Until further notice, ALL services will be VIRTUAL.

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