Forms and Documents

If you are a new patient seeking your first appointment, please click on the New Patients Book Now! button on top of this page.

Measures and Forms

Behavioral Health Measures

Your healthcare provider at Inspired Psychiatric Care may occasionally ask you to complete specific behavioral health measures to get more specific about your condition. Please do not submit a form unless asked to do so by your provider.

Administrative Forms

You can use these forms to update your credit card information or insurance information. You can also use Consent to Release Information if you want IPC to share your information with a non-IPC provider, practice, hospital or inpatient clinic. Your provider may also ask you to complete the Controlled Substance Agreement in some cases.

Behavioral Health Measures
Abnormal Involuntary Movement Scale (AIM)https://intakeq.com/new/8BpFCG/n1gsif
Adult ADHD Self-Report Scale Symptom Checklisthttps://intakeq.com/new/8BpFCG/e4gram
Adverse Childhood Experience (ACE)https://intakeq.com/new/8BpFCG/kvibhm
Alcohol Use Disorders Identification Testhttps://intakeq.com/new/8BpFCG/n1gsif
Beck Anxiety Inventory (BAI)https://intakeq.com/new/e0A5G6/alat1q
Beck Depression Inventoryhttps://intakeq.com/new/8BpFCG/l6lt8g
Beck Hopelessness Scalehttps://intakeq.com/new/e0A5G6/fwxinh
Brief Psychiatric Rating Scalehttps://intakeq.com/new/8BpFCG/b4g0og
CAGE-AID Adapted to Include Drugshttps://intakeq.com/new/8BpFCG/3lgj0r
Clinical Opiate Withdrawal Scalehttps://intakeq.com/new/bdxy0f/3lgj0r
EMDR Dissociative Experiences Scalehttps://intakeq.com/new/e0A5G6/e1ta1v
Endinburgh Postnatal Depression Scale (EPDS)https://intakeq.com/new/e0A5G6/rc16wz
Geriatric Depression Scale (Long Form)https://intakeq.com/new/e0A5G6/wiiesh
Geriatric Depression Scale (Short Form)https://intakeq.com/new/e0A5G6/thpu9x
Mood Disorder Questionnairehttps://intakeq.com/new/e0A5G6/wdnekb
OCD Screenhttps://intakeq.com/new/e0A5G6/mpfwfa
Post-Traumatic Stress Disorder Checklist – Specifichttps://intakeq.com/new/e0A5G6/ev9wji
SCID Major Depressive Episode Screenhttps://intakeq.com/new/e0A5G6/rypjbp
SCID Manic Episode Screenhttps://intakeq.com/new/e0A5G6/zf9ao6
*Suicide Ideation Intensityhttps://intakeq.com/new/e0A5G6/q2fbj3
Trauma Questionnairehttps://intakeq.com/new/e0A5G6/vsj4e6
Vanderbilt ADHD Parent Rating Scalehttps://intakeq.com/new/e0A5G6/qjw3uq
Vanderbilt ADHD Teacher Rating Scalehttps://intakeq.com/new/e0A5G6/exbdkx
Administrative Forms
Consent to Release Informationhttps://intakeq.com/new/8BpFCG/t7rle0
Credit Card on File Consent Formhttps://intakeq.com/new/e0A5G6/ytnfag
Insurance Information Updatehttps://intakeq.com/new/e0A5G6/wiiesh
Controlled Substance Agreementhttps://intakeq.com/new/e0A5G6/oudged

Documents Available to Download/View

Your Partner for All Ages . . .