New Patient Form for Reno Psychiatric Associates - Transition Paperwork
For patients continuing with Dr. Chris Charles or Dr. Kim Charles
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We utilize an encrypted service with Google Forms to obtain initial health information as part of your preliminary assessment process.  Once these electronic assessment forms that you complete are downloaded,  they are deleted from the Google service approximately every 90-days in an effort to further secure your protected health information from disclosure.  All completed and downloaded documents from Google Forms, are part of the permanent medical record and retained in your medical record at our office.
Thank you for choosing to follow Dr. Chris Charles or Dr. Kim Charles in the transition to Reno Psychiatric Associates (RPA). The following is the paperwork that needs to be completed prior to your appointment.  All scheduled appointments will remain unchanged unless you notify our new office.  This paperwork will also serve as our annual demographic update to verify address and insurance changes.

Please read through this paperwork carefully as some of the policies are different.  

We will continue to accept the same insurance plans.  

Please complete this form to the best of your ability. If you are doing this on behalf of someone else, please indicate this.

We look forward to continuing our relationship with you and appreciate you completing this paperwork.

On the day of your appointment
We will need:
- copy of your insurance card
- copy of your photo ID

Please arrive at least 15 minutes prior to your appointment to check in. If you do not arrive on time, you may be asked to reschedule.

We will attempt to call you 1 day prior to your appointment to confirm your visit.  We require 24 hours notice for changes or cancellations of appointments. Unconfirmed appointments are subject to cancellation.

All copayments, deductible and/or coinsurances will be collected at the time of check in.  The office accepts cash, VISA, Mastercard, and debit cards.  THE OFFICE DOES NOT TAKE CHECKS.

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