Patient Forms and Downloads

The 18 and Up Patient Forms are:

New Patient Packet - 18 and Older

The Under 18 Patient Forms are:

New Patient Packet - Under 18

Other Important Forms

Release of Information (PDF)

Please Note: There will be a $30 processing and additional $5 shipping and handling fee for the copy and transfer of medical records. We appreciate your cooperation.

Clinical Research Trials

Teen Depression, Ages 12-17

Adult Depression, Ages 18-65

Adult Depression & Anxiety, 18-65

Adult ADHD, Ages 18-55

Teen Smoking Cessation, Ages 12-16


To learn more, please contact Lori Niewiarowski at

or by phone at (248) 608 8800 ext. 249