Intake Forms

psychiatry patient forms illustration

If you are a new Psychiatry or Psychotherapy patient, please complete all of the intake forms listed below before scheduling your first online visit.

For new Medical Weight Management patients, please fill out this online Medical Weight Management Intake Form.

For new Personal Coaching clients, I'll e-mail you a separate intake form.

You can easily fill out all the forms online via our HIPAA-compliant, securely encrypted Jotforms (just click on the form names below).

For the Credit Card Authorization form (Form #5), please fill out the fillable PDF, download it to your computer, and then email it to my confidential and HIPAA-compliant email at

(1) New Patient Evaluation

(2) HIPAA Notice and Acknowledgement Of Receipt

(3) Office Policies

(4) Services/Fees and 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 Today

At The Happiness Psychiatrist®, our patient philosophy centers around treating the whole person: mind, body, and spirit.
We believe that the judicious use of psychopharmacology, coupled with psychotherapy and other integrative 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, OCD, and other common mental health conditions and life issues.

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

We're 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 Hudson Valley area.

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