Dr. Marilyn Kieffer-Andrews -- New Patient Information and Forms

New Patient Information and Forms

What you can expect from your first visit.

The forms that you complete prior to your first visit will be reviewed with you by Dr. Kieffer-Andrews to confirm your history and background. She will make brief notes as she is doing this.
Your primary needs and goals will then be identified.
Discussion regarding insights, clarifications, modalities and realistic goals are formed and mutually agreed upon.
Medications will be discussed only as appropriate or requested
A schedule for follow up will mutually agreed upon.

New Patient Forms:
Please Complete all Forms in total PRIOR to arrival at your first visit. It allows a quick review of your history and concerns and makes maximum use of your 50 minute visit. You will lose part of your 50-minute visit time if not completed.

We do honor your time and make every effort to begin and end on time. If you are late, your session will end on time.

Identifying information:
Privacy Policy (HIPPA) with separate form to sign acknowledging receipt
Financial Policies and Agreements
Family and Social History
History of Prior Counseling, Treatment, Medications
Primary Presenting Issues

Marilyn Kieffer-Andrews, RNP, Ph.D

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New Patient Information and Forms