Welcome to Contemplative Medicine!
The first sheet is demographic information that we use to get you set up into our system. The psychiatric client agreement is yours to look over and keep for your own records, but we do need the last sheet signed and returned. The final packet is the very fun, medical history and self-assessment packet. Upon return of this screening packet, we will need a couple releases signed, the $50 fee, and to make/get a copy of your picture ID and insurance card, if you have one (for prior-authorization purposes). If you have any questions, or want to know/set up a time to complete/set you up with the intake, or anything else, please call (607)215-1705. It can be emailed back to: firstname.lastname@example.org, mailed to 38 Riverside Drive, suite 3, Binghamton,NY 13905 or faxed over to 1-607-203-1668.