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New Client Paperwork
Registration & Medical History Forms
**Prior to completing intake info, please email contact@mosaicpsychiatriccare.com to confirm the wait time for a New Patient appointment.**
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Socially awkward, perfectionist, hard working people pleasers welcome!
For convenience, all registration, consent, insurance/ payment info and signatures can be submitted electronically via the secure, HIPAA-complaint portal below. It is recommended to use a computer or tablet to submit forms (vs mobile phone).
online mental health treatment, online mental health therapy
Downloadable Paper Copies
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Alternatively, you can download & complete both the consent for treatment and the appropriate registration form, and return the completed forms via fax.
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