Patient Forms
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Any disclosure of personal health information requires a ROI. Please complete the form and email to info@modernpsychcenter.com.
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All patients on a stimulant medication treatment, please review, sign, and email the form to info@modernpsychcenter.com.
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Please return signed form to info@modernpsychcenter.com.
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Written parental consent is required for any patient younger than 18 years of age. Currently, MPC does not treat anyone younger than 17 years of age. Complete the form and email to info@modernpsychcenter.com.