Client Forms
New Patients
Please review and complete New Patient Registration Packet (form 1). Answer the questions and push submit when complete. Your documents will be sent to us directly and securely. * (You may also print a PDF version using the PDF button on the right.)
Once completed, please check your email for instructions to set up an account through our patient portal from Valant. Once your Valant patient portal is set up, you will be emailed clinical documents that must be completed before your appointment.
* Form 4 is a HIPAA Privacy Notice for your review only and is available to print.
Please use the UPLOAD link below to send us a copy of your insurance card (front and back) and a photo ID.
For ALL NEW patients and follow-up appointments with Dr. Telford, please complete the COVID-19 Patient Questionnaire and Waiver (form 5) prior to each in-person visit. (This is not required for your daily TMS appointments.)
If you are scheduled for a telemedicine visit with Dr. Telford you will need you to fill out a Telemedicine Consent (form 2) before your appointment.
All Forms are secure Electronic submissions. (except for form 4) If you prefer to download the forms, please use the PDF button to the right of each form, fill out, and fax to our office.
Please review and complete the New Patient Registration Packet (form 1.)
Answer the questions and push submit when complete. Your documents will be sent to us directly and securely.* (You may also print a PDF version using the PDF button on the right.)
Once completed, please check you email for instructions to set up an account through our patient portal from Valant. Once your Valant patient portal is set up, you will be emailed clinical documents that must be completed before your appointment.