Get Lila Massoumi

This guide provides step-by-step instructions on how to fill out the Lila Massoumi form online. By carefully following these directions, users will ensure all required information is accurately submitted.

Follow the steps to complete the Lila Massoumi online form.

1. Press the ‘Get Form’ button to obtain the online form and open it in your preferred editor.
2. Begin by filling out your personal information, including your first and last name, street address, and other contact details. Ensure all information is current and accurate.
3. Provide your date of birth, age, and marital status. For marital status, check the appropriate box that applies to you.
4. Indicate your employment status by selecting either 'Employed' or 'Unemployed.'
5. Enter your preferred method of contact by specifying which phone number is best to reach you. Indicate whether you wish to receive voicemails on the number provided.
6. Fill out the 'Insurance Information' section with details about your insurance provider, including the enrollee ID and group number, if applicable.
7. Provide an emergency contact's name and phone number, along with the relationship to you. This is an important part of your emergency plan.
8. Review all provided information carefully for accuracy, as this information helps in establishing your care.
9. Sign and date the form in the designated area, indicating your consent and understanding of the provided services.
10. Once all information is completed and verified, you can proceed to save your changes, download the document, print it, or share it as needed.

Complete your forms online to streamline your visit with Integrative Psychiatry Services.