Drs Richard and Julie Bingham

Drs Richard and Julie BinghamDrs Richard and Julie BinghamDrs Richard and Julie Bingham

Drs Richard and Julie Bingham

Drs Richard and Julie BinghamDrs Richard and Julie BinghamDrs Richard and Julie Bingham
  • Home
  • Patient Info/forms
  • Dr Julie Bingham
  • Dr Richard Bingham
    • Home
    • Patient Info/forms
    • Dr Julie Bingham
    • Dr Richard Bingham

  • Home
  • Patient Info/forms
  • Dr Julie Bingham
  • Dr Richard Bingham

COVID-19: All visits are currently via telemedicine.

image217

Dr Julie Bingham, PhD.

Dr Richard Bingham, M.D.

Dr Richard Bingham, M.D.

Click Link below if you are scheduled for a telemedicine appointment with Dr. Julie

sign in
image218

Dr Richard Bingham, M.D.

Dr Richard Bingham, M.D.

Dr Richard Bingham, M.D.

 Click Link below if you are scheduled for a telemedicine appointment with Dr. Rick

sign in

New patients

New patients will need to complete the initial patient paperwork and either mail, email or fax the forms to our office.  We are typically scheduled about 8-12 weeks out depending on availability. Once we receive your paperwork, our office will give you a call and schedule you for an initial evaluation appointment. There is a one time $55 clinical fee that is no covered by insurance, that we will collect information and concerns from for your initial evaluation. 


All forms needed for the initial registration can be found below. 


New Patient Forms/Releases

NEW Patient Registration Paperwork Dr Julie Bingham (pdf)Download
Release of Information - Dr Julie Bingham (pdf)Download
Telemedcine Release- Dr Julie Bingham (pdf)Download
NEW Patient Paperwork Dr Richard Bingham (pdf)Download
Release of Information - Dr Richard Bingham (pdf)Download
Telemedicine Release - Richard Bingham (pdf)Download
Family History and Background Form (pdf)Download
Summary of Problems Write Up (pdf)Download

patient questionnaires

Below are questionnaires that Dr Richard  Bingham or Dr Julie Bingham may request the family to complete to gather more information.

ADHD RS teacher (pdf)Download
ADHD RS (pdf)Download
ASSQ (pdf)Download
GBI (pdf)Download
Parent DISC (pdf)Download
Patient DISC ages 12 and up (pdf)Download
Parent Mood Check (pdf)Download
Patient Mood Check (pdf)Download
SCARED Child (pdf)Download
SCARED parent (pdf)Download