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Copyright 2011 Dr. Cheryl Hodges, M.D.

New Patients’ Forms

New Patients

The New Patient Information forms, listed below, are an important part of Dr. Hodges getting to know you and providing the best possible medical treatment for mental health issues you are experiencing.
Please download the 3 forms below, complete them and return to our office by faxing, mailing, or dropping off these forms to our office at least 2 working days prior to your appointment.
Please do not email the completed forms.

Please call your insurance company before your first appointment to verify that Behavior Healthcare is part of your plan and ask if prior authorization is required.
If you have any questions please call our office.

Welcome Note & Practice Policies

Patient Information Form

Patient Medical History Form

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