Welcome to Milestone Psychiatry.

Please take a few minutes to complete the following form. If the form is Intake Paperwork the last page is a release of information. Fill this out if you would like us to request records from another provider prior to your session. We will not share or obtain any patient information with anyone without written permission, ROI (unless required by law).

You may also be receiving other forms such as a release of information, our 2023 updated policies and procedures, or a credit card authorization form. Please fill out the forms accordingly and sign where nesseccary before your next appointment.

If you scheduled an in person session and do not complete the forms prior to your session you are expected to arrive 10-15 minutes early to do so. Be sure to bring picture ID and insurance card(s).

If you scheduled a telemed session the forms must be completed a minimum of 48 hours prior to your scheduled appointment time or your appointment will be cancelled. The day before your appointment you will receive an email containing the video link for your session, provided your forms are completed. Please email a copy, picture or snapshot of your ID and Insurance card to frontdesk@milestonepsychiatry.com .

Please note:

We are in network with Aetna, Anthem Blue Cross Blue Shield, Cigna, Humana, Medicaid, Medicare, Optum/UHC and Tricare. Copays are due at the time of session. If you do not have one of these insurances you are expected to self pay ($175 for initial session, $125 for follow up). 

 

 

For your protection and security; information you enter will be encrypted and safely sent directly to our office once you complete all sections. Navigating away from this form system or allowing it to “Time Out” before clicking "Submit" will cause the dismissal of any entered data. After successful submission you will be redirected to a Confirmation/Thank you page.