New Patient Intake Forms

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These forms can be completed online by enabling editing and emailed to  Contact@ColoPsychiatric.com 

or printed & mailed or faxed. 

Please include copies of both sides of the insurance card(s) and driver's license.

Please let us know why you are needing an appointment 

and your current & previous psychiatric medications.

We will reply by email once the completed forms, cards and pharmacy records have been reviewed & approved. 

PLEASE NOTE:    

We do not prescribe addictive medications,  and can not see patients who are Using 

or requesting addictive medications. 

We do not complete assessments, evaluations, applications or re-applications for disability, FMLA, EAP or ESA,  can not see patients on disability or considering applying for disability, and do not do forensic psychiatry.

We do not accept out of network, uninsured, self-Pay or Medicaid, patients living in facilities, homeless 

or needing injectable psychiatric medications. 

  Please contact your insurance carrier for a list of providers who offer these services.