TMS Clinic 2025

1. Click ‘Get Form’ to open the TMS Clinic intake packet in the editor.
2. Begin by filling out the 'Patient Information' section. Enter your last name, first name, middle name, date of birth, phone number, email, gender, relationship status, race/ethnicity, and preferred pronouns.
3. Next, complete the 'Address' field by providing your apartment number (if applicable), city, state, and zip code.
4. Proceed to the 'Primary Insurance Information' section. Fill in details such as insurance provider, policy holder's name and date of birth, insurance number, group number, and your relationship to the policy holder.
5. In the 'Referring Provider' section, ensure that your referring provider fills out their information including name and office contact details. Confirm if TMS was discussed as a treatment option.
6. Complete the 'Safety Screen for TMS Candidates' by answering all questions honestly regarding your medical history and current health status.
7. Fill out sections on psychiatric and medical history thoroughly. Include current medications and any known allergies.
8. Finally, review all entries for accuracy before saving your completed form. Once finished, you can easily share it via fax or mail as instructed.

Start using our platform today to streamline your TMS Clinic intake process effortlessly!