Get Please Download, Print, & Bring Filled Out To Your First Appointment.

Filling out the Please Download, Print, & Bring Filled Out To Your First Appointment. form is an essential step in preparing for your first appointment. This guide will provide you with easy-to-follow instructions to ensure you complete the form accurately and efficiently.

Follow the steps to effectively fill out the form.

1. Click ‘Get Form’ button to obtain the form and open it in your preferred editing tool.
2. Begin by clearly writing the patient’s name in the designated space. This section is crucial as it identifies the individual receiving care.
3. Enter the patient’s date of birth in the appropriate field. This information helps verify the patient’s identity.
4. Fill in the treating provider's information: Write the provider's name, phone number, address, and fax number to ensure appropriate contact for care coordination.
5. Indicate the problems for which the patient is being treated by checking the corresponding boxes. This includes options like mental health diagnosis, chronic illness, medication management, and more.
6. Provide the treatment start date in the specified area, and record the date of the last appointment to track the patient's care timeline.
7. Write down the expected date for the next appointment to help with scheduling and follow-up.
8. List any medications and dosages in the spaces provided. Ensure you include all relevant medications for accurate medical history.
9. Document significant information impacting medical or behavioral health, including past hospitalizations or descriptions of chronic medical illnesses, in the designated section.
10. If you wish to discuss the patient’s treatment further, note the additional instruction for contacting the practitioner using the provided number.
11. The practitioner should sign and date the form in the specified areas to authorize the information provided.
12. Once all sections are completed, you can save the changes, download the document, print it, or share it as required.

Complete your form now and ensure a smooth start to your appointment.