To become a patient, please phone me during regular business hours at 650-427-0779 or email to email@example.com (please review Email section below).
If I do not answer or if you are emailing your request, please leave a message with your name, preferred phone number and some best days and times to return your call.
Please note that, because I accept many major insurance companies, my practice is typically very full and thus I regret if I am unable to accommodate further new patients at the time of your call. Also, I am unable to maintain a waiting list for my services. Due to the volume of new patient inquiries I typically receive, I make every effort, but I apologize that I often will be unable to respond to your inquiry directly.
Before scheduling any initial meetings, I require that we have a brief 1:1 phone consultation. We will need to discuss what sorts of problems you are experiencing and what sorts of needs and expectations you have regarding evaluation and treatment options. If I do not believe I can meet your needs and expectations, I will do my best to refer you to a colleague who can better assist you.
Also, please note that my practice is typically restricted to new patients between the ages of 18 to 65.
My professional email is firstname.lastname@example.org
Please note that all email communication with me will not be conducted via a secure server. Thus, consider any email to me like a "postcard" which potentially could be viewed accidentally by unintended persons. Thus email should be used only for non-sensitive and non-urgent matters.
I have found email communication to be an un-intrusive communication tool to assist with non-urgent matters, e.g. refill requests and especially appointment scheduling.
I read email daily and most messages are replied to within 24 hours. If greater than 48 hours is exceeded without an expected reply from your email, please consider that I may not have received your email and so please phone me directly to discuss your query.
Also, for established patients, please note that you will receive an appointment reminder via email typically 2-3 days prior to any scheduled visit.
Please see the attached Email Consent Form below for further information.
First Appointment “Welcome Email”
A “Welcome Email” will be sent to you after we schedule our first meeting. Please email reply back to me after receiving this email to confirm our first meeting.
Attached to the “Welcome Email” will be several initial documents and several questionnaires specific to your situation.
Please print out and complete the forms as indicated, sign them, and either fax them back to me at my confidential fax (888-959-7897, no cover page required, it is a direct fax to me) or mail them to me at my mailing address (P.O. Box 60338, Palo Alto, California 94306-0338) or bring them to our first meeting.
First Appointment Checklist
· Please review this web site
· Please review my web page “Directions and Map to the Office”
· Please review my web page “Confidentiality in Therapy” web page
· Please review my web page “HIPPA: Notice of Privacy Practices for Protected Healthcare Information”
· Please review the “Treatment Contract and Agreement to Pay for Professional Services” attached as a document on the bottom of this web page. This contract will be reviewed together and signed at the end of our first meeting.
· Please complete:
· any initial questionnaires and/or surveys attached to your “Welcome Email”
· the Demographic Information Form
· an Email Consent Form
· any Release of Information Forms, as applicable
· Please also bring, as applicable and available
· Contact Information for any past and present doctors and therapists
· Prior Records, if available
· Medications, if applicable
· Insurance card/information
· Please also bring cash, personal check, credit card or debit card for payment/co-payment due at time of service.