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(480) 508-0882

Scottsdale  |  Tempe

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Scottsdale Mental Health and Wellness Institute
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Patient Forms

1. New Patient Registration-Demographics
2. Privacy Policy Receipt
3. HIPAA Form – Others release to Scottsdale Mental Health and Wellness Institute
4. HIPAA Form – Scottsdale Mental Health and Wellness Institute release to others
5. Patient Contract

6. Non-Insurance Fee Schedule
7. No-Show Policy
8. Medication Consent Scottsdale Mental Health and Wellness Institute
9. Credit Card Authorization Policy

CONTACT

Scottsdale

Tempe

TEL: (480) 508-0882

FAX: (480) 508-0891

EMAIL: admissions@smhwi.com

RESOURCES

  • Pre-Registration Form
  • Insurance Providers List
  • List of Services
  • New Patient Forms

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    • Forensic Evaluations in Scottsdale
    • General Psychiatric Treatment in Scottsdale
    • Geriatric Psychiatry in Scottsdale
    • Intensive Outpatient Treatment in Scottsdale
    • Outpatient Individual Psychotherapy in Scottsdale, AZ
    • Psychiatric Return to Work Program in Scottsdale
    • Psychosomatic Evaluation and Treatment in Scottsdale
    • Tele-Psychiatry in Scottsdale, AZ
    • Workers’ Compensation Treatment in Scottsdale, AZ
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  • Suboxone Treatment in Scottsdale, AZ
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