Forms & Documents

New Patients Forms

Please print, review and sign these forms and bring them with you upon your first visit.

• Intake Information

• Office Policies and Financial Agreement

• Medicare Agreement Doctor Patient

• Release of Information

• Credit Card Authorization Form

Additional Forms

After contacting Dr. Stefanik you may be directed to download one or more of the following.

• Adult ADHD Screening Tool

• Beck Depression Inventory

• CES-D Depression Screening

• MADRS

• Mood Chart

• Mood Disorder Questionnaire

• PHQ-9 Nine Symptom Checklist

• YBOC Form for OCD

• Zung Depression Inventory

• Zung Self-Rating Anxiety Scale