Call us today: 732-655-4568 | 119 Maple Ave. Red Bank, NJ 07701 | Hours: Mon-Fri 9am – 6pm

Forms and Portal

Patient Portal

For a simplified and efficient start with us, please use the patient portal to fill out your new patient forms before your appointment.

Patient Forms

Please provide your credit card details via our encrypted patient portal form for secure appointment payments.

To comply with state laws and ensure the responsible prescription of stimulants to minors, please complete the required telehealth consent form.

Please take a look at our office policies form to make sure you’re familiar with our office policies to help us provide you with the best care experience during your visit.

A release of consent form is required to authorize and facilitate the sharing of your health information between our office and your primary care provider.

A release of consent form is required to authorize and facilitate the sharing of your health information between our office and your therapist.

A release of consent form is required to authorize and facilitate the sharing of your health information between our office and your family member.

Self-Assessments

These self-assessments are not intended to be used as a diagnostic tool. Only a trained medical professional can accurately diagnose mental health conditions. These medically-reviewed assessments are designed to help you assess your well-being and determine if you may benefit from a consultation with a professional.

Child and Adolescent Screeners

Vanderbilt Scales (Parent)- The Vanderbilt scale is a parent questionnaire to screen for Attention-deficit hyperactivity disorder (ADHD) in children.

Vanderbilt Scales (Teacher)- The Vanderbilt scale is a teacher questionnaire to screen for Attention-deficit hyperactivity disorder (ADHD) in children.

(Parent and Child Version) – The SCARED is a child and parent self-report questionnaire used to screen for childhood anxiety disorders and monitor symptoms. The questionnaire is for children ages 8 -18 years

Child Depression Inventory (CDI) is a self-report assessment that measures depression symptoms in children.

Adult Screeners

Adult ADHD Self-Report Scale (ASRS) is an 18-item self-report questionnaire designed to assess Attention Deficit Hyperactivity Disorder (ADHD) symptoms in adults (18+)

General Anxiety Disorder (GAD-7) is a self-reported questionnaire for screening and measuring the severity of generalized anxiety disorder.

Patient Health Questionnaire (PHQ-9) is a nine-item depression scale that can act as a screening tool, aid in diagnosis, and as a symptom tracking tool through treatment.

Patient Health Questionnaire (PHQ-9) is a nine-item depression scale that can act as a screening tool, aid in diagnosis, and as a symptom tracking tool through treatment.

Mood Disorder Questionnaire (MDQ) 15-item self-report screener for symptoms of bipolar disorder.