Patient Forms

To make it easier on our patients, you can fill out and submit most forms online.

Below you will find our primary forms that all patients must fill out. Most of these can be filled out and submitted online, with the "INTAKE FORM" being the exception. The Intake Form must be printed, filled out manually and brought with to your appointment.

NOTE: If you do not want to fill these out online, you will also find download buttons for each that will allow you to print them and fill out manually. Just remember to bring them with to your appointment.

PATIENT
INTAKE

PATIENT
REGISTRATION

- or -

FINANCIAL
RESPONSIBILITY

OFFICE
POLICIES

- or -

TREATMENT
CONSENT

- or -

TELEMEDICINE
CONSENT

- or -

PRIVACY POLICY
ACKNOWLEDGEMENT

NOTICE OF PROVIDER
PRACTICES

ELECTRONIC
COMMUNICATION
CONSENT

Psychiatric Services of Prescott Logo
143 E Merritt Street
Prescott, AZ 86301
(928) 776-7400

Business Hours

Monday: 8:30am – 5pm
Tuesday: 8:30am – 5pm
Wednesday: 8:30am – 5pm
Thursday: 8:30am – 5pm

Fri, Sat, Sun: CLOSED