Intake Forms

psychiatry patient forms illustration

If you are a new Psychiatry or Psychotherapy patient, please complete all of the following forms, including the credit card authorization form, before requesting to schedule your first appointment.

If you are a new Medical Weight Loss or Coaching client, Dr. Ambardar will e-mail you a separate set of intake forms.

The forms below may be filled out and submitted directly online via our HIPAA-compliant, securely encrypted Jotforms (please click on the form names below).

For form #5, (the Credit Card Authorization form), please click to complete the fillable PDF, download to your computer, and then e-mail to our confidential, HIPAA-compliant e-mail at

(1) New Patient Evaluation

(2) HIPAA Notice and Acknowledgement Of Receipt

(3) Office Policies

(4) Treatment Consent

(5) Credit Card Authorization Form

(6) Telepsychiatry and Teletherapy Consent

(7) Open Payments Database Written Notice

(8) Medical Board of California Acknowledgement

Feel Happier

At The Happiness Psychiatrist®, our patient philosophy centers around treating the whole person: mind, body, and soul. We believe that the judicious use of psychopharmacology, coupled with psychotherapy, and other alternative treatments (such as meditation, Kundalini yoga, and walking therapy), can bring about transformative changes in the lives of those suffering from depression, anxiety, bipolar disorder, binge-eating disorder/overweight, OCD, and other common mental conditions and life issues.

As a female psychiatrist-owned online business, we are proud to serve all parts of California, including the Los Angeles, Beverly Hills, Santa Monica, West Hollywood, Westwood/UCLA, Pasadena, Malibu, Burbank, San Francisco, Marin County, Portola Valley, Palo Alto, Stanford, Silicon Valley, Cupertino, Menlo Park, and San Jose areas.

We are also proud to serve all parts of New York, including New York City, Manhattan, Brooklyn, Greenwich Village, the Upper East Side (UES), the Upper West Side (UWS), the West Village, and the East Hampton and Southampton areas.

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