Forms & Paperwork

Patient Portal Login Don’t have access to Portal – request access on Contact Us page. USE CHROME TO ACCESS PORTAL
Telehealth Links Click here to reach the telehealth appointment page, then click the doxy link to the right of your clinician's name for your appointment.

Completed new patient paperwork is required at the initial appointment for EACH PRA clinician that you see. Our paperwork serves as consent to treatment and there must be one on file for each clinician you see at PRA. All forms to be completed for your initial appointment are available below. If you are seeing a THERAPIST, click New THERAPIST Patient Paperwork. If you are seeing one of our psychiatrists/MD’s – Click all the listed forms under their name.

Please bring your insurance card and photo ID to your first appointment!
Pay Now

DROP BOX IS A HIPAA COMPLIANT WAY TO SEND DOCUMENTS TO OFFICE STAFF AT PRA. SAVE YOUR DOCUMENT WITH YOUR FULL NAME, HIT DROP BOX LINK, PICK THE STAFF PERSON YOU WANT TO SEND IT TO AND THEN FIND YOUR DOCUMENT THEN UPLOAD. SEE INSTRUCTIONS.

IN PERSON OFFICE SESSION GUIDELINES DURING COVID-19

IF USING FILLABLE FORM, SAVE THE FORM AS YOUR FULL NAME, AFTER COMPLETING, THEN SEND TO OUR OFFICE!!! OTHERWISE IT WILL COME TO US BLANK!!! PRINT ALL FORMS AS INDICATED WHEN MAKING APPOINTMENT

IF USING FILLABLE FORM, YOU MUST SAVE THE FORM AFTER COMPLETING BEFORE SENDING TO OFFICE!!! OTHERWISE IT WILL COME TO US BLANK!!! PRINT ALL FORMS AS INDICATED WHEN MAKING APPOINTMENT

TELEHEALTH CONSENTS AND OTHER INFORMATION

FOR PATIENTS 13 - 17 years of age, please complete the Parent Questionaire and Behavioral Checklist. ALL PATIENTS please complete PHQ9 and GAD7 - please note if insurance does not cover these two assessment, you will be responsible for no more than $10 total. POLICY AND PROCEDURE - REVIEW AND KEEP AS REFERENCE.

Please have these additional forms completed prior to your first appointment. Forms are fillable - once completed in adobe, SAVE AS and rename document with patient name.

PLEASE COMPLETE THESE ADDITIONAL FORMS AND RETURN WITH OTHER INTAKE PAPERWORK - REMEMBER TO SAVE AS - WITH YOUR NAME.

Please print and complete the forms prior to the appointment if scheduled with Dr.Jason Chang. Please also print any release of information or other forms that may apply. Bring to initial appointment. DO NOT PRINT DOUBLE SIDED

Please print and complete the forms prior to the appointment if scheduled with Dr. Sandy Rhee. Please also print any release of information or other forms that may apply. Bring to initial appointment. DO NOT PRINT DOUBLE SIDED

Please print and complete the forms prior to the appointment if scheduled with Dr. Ella Komarovsky. Please also print any release of information or other forms that may apply. Bring to initial appointment. DO NOT PRINT DOUBLE SIDED

Please print and complete the forms prior to the appointment if scheduled with Dr. Donna Woods. Please also print any release of information or other forms that may apply. Bring to initial appointment. DO NOT PRINT DOUBLE SIDED

Please also print any forms from the Additional Forms section, that apply.

Please also print any forms from the Additional Forms section, that apply.

Print any that apply.

FOR PRA PERSONNEL ONLY