Dr. Julie Bingham

Dr. Julie BinghamDr. Julie BinghamDr. Julie Bingham

Dr. Julie Bingham

Dr. Julie BinghamDr. Julie BinghamDr. Julie Bingham
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  • Dr Julie Bingham

All visits are currently via telemedicine.

Dr Julie Bingham, PhD.

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

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New patients

Please mail all forms to P.O. Box 3173, Salem, OR 97302

**WE ARE CURRENTLY CLOSED TO NEW PATIENTS AT THIS TIME**


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

Currently Updating: Please mail all forms to P.O. Box 3173, Salem, OR 97302. The address on the forms are for our old location. 

Release of Information Dr Julie BIngham (pdf)Download
Release of Information Dr Richard BIngham (pdf)Download
NEW Patient Registration Paperwork Dr Julie Bingham (pdf)Download
Telemedcine Release- Dr Julie Bingham (pdf)Download
Summary of Problems Write Up (pdf)Download
Family History and Background (pdf)Download
New Patient Paperwork-Adult-Dr Julie Bingham (pdf)Download
Adult Family And History Background (pdf)Download
Dr Julie HIPAA handout npp_booklet_hc_provider (PDF)Download
Dr Rick HIPAA handout npp_booklet_hc_provider (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