Patient Forms
For All New Patients:
Welcome to Westmed Behavioral Health. Before your visit, we’d like you to look over and sign our patient -Therapist Agreement , which you can access here. If you have any questions, we’re happy to discuss it with you in your session.
If you are not using your insurance to pay for your visit, Please complete our self-pay form, which you can access here and bring it with you to your visit.
At Westmed Behavioral Health, we use a variety of measurement tools to help diagnose and guide treatment. We’d like you to complete some of these forms in advance of your first appointment. You can find the links to our forms below. Please print them out and complete them before your visit
For All Child & Adolescent Patients:
For Children Ages 8-17:
- Depression Scale – Center for Epidemiological Studies
- Screen for Child Anxiety Related Disorders (SCARED)-(PARENT FORM)
- Screen for Child Anxiety Related Disorders (SCARED)-(CHILD FORM)
For ADHD Evaluation:
- Adult ADHD Symptom Checklist
- NICHQ Vanderbilt Assessment Scales (FOR PARENTS)
- NICHQ Vanderbilt Assessment Scales (FOR TEACHERS) – please have two different teachers complete a form.
After Your Visit:
If your provider has asked you to complete a “release of information form” so that he or she may communicate with an outside therapist, a school, or obtain psychiatric records, please download and print this form.
Download the My Westmed User Guide to learn how to open a My Westmed portal account or gain access to your children’s accounts so that you may securely message their providers. Our behavioral health team prefers this mode of communication for non-emergency information.
