New Patient Form for Reno Psychiatric Associates - Transition Paperwork
For patients continuing with Dr. Chris Charles or Dr. Kim Charles
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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.
Dr. Christopher Charles
Dr. Kimberlee Charles
I am not currently seeing either of the above providers, and I do not have a scheduled appointment with either provider.
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