Julie Evans Bingham, Ph.D.



Now that you've scheduled the assessment take these steps:

Completing paperwork before our appointment time will allow us to best use our time together and make the evaluation process more complete.  There are a couple of ways you may choose to do this.  First, decide whether you want to complete the paper work before you come in for your appointment.  If you do, read the steps below; if not, arrive 30 minutes early for the first appointment and look for the appropriate clipboard for new patient forms labeled either, "Adult" or "Child."  Either way, keep track of any questions you may have about the forms and let me know when I see you.  We will spend time to address any questions and make sure this process is understandable for you.  Note: if there is joint custody of a child patient, both parents will need to sign the forms. 


Before you come in, complete the following and bring them to the first appointment:

  1. Print, read, and sign the Consent form to bring with you.

  2. Print and complete the Registration form (child patient or adult patient).

  3. Print and complete the Background Questionnaire (child or adult).

  4. Print and complete a Release of information form.  This is to exchange information with your primary care physician, and we may add others to this list as needed.  Complete the names, check both the "To" and "From," fill in the you or your child's doctor's name (no need to put the address if they are local), check "yes" for the entire record (usually the assessment summary is sent, and sometimes some later notes), and sign your initials next to the "psychiatric and drug abuse" lines, and sign and date.

  5. Print and complete the Initial Clinical Questionnaire (child or adult).