Plymouth Psych Group has created the following forms to obtain important information to better care for you and your family.
To expedite your check-in experience, please complete all forms and bring them with you to your appointment. If you are not able to do so, please arrive 15 minutes before your scheduled appointment to complete them in our office.
Also, please be sure to bring a copy of your insurance card to your first appointment.
For Your Initial Intake Appointment
Printable Forms
- Registration
- Patient History
- Release of Information
- Practice Policies
- Informed Consent Packet
- Psychiatric Controlled Substance Management Agreement
- Telehealth – Consent for Treatment
Online Fillable Forms
- Psychiatric Controlled Substance Management Agreement
- Release of Information
- Telehealth – Consent for Treatment
- Credit Card on File Authorization
- Employee Health Screening Form
- Optum Scholarship Form