Welcome.
Before our first appointment, please complete the intake forms below. Each takes only a few minutes.
Forms are signed electronically and a record is kept securely on file. Once you complete the first form, your name and date of birth carry forward so you don't have to re-enter them.
Personal information, contact and pharmacy details, clinical history, and (if applicable) parent/guardian information for adolescents.
How your protected health information is used, your rights under HIPAA and California's CMIA, and your preferences for communication.
Risks, benefits, and ground rules for video and phone visits, including emergency procedures and recording policy.
Fee-for-service policy, 48-hour cancellation policy, and authorization to charge your card on file for sessions and missed appointments.
Submit your Visa or Mastercard securely. The Practice never holds your full card number — only a tokenized reference held by the payment processor.
Required for patients age 65 or older. Acknowledges that Dr. Wong has opted out of Medicare and that no claim will be submitted on your behalf.
Required if the patient is under 18. Both parents or legal guardians must consent to psychiatric treatment of a minor.
Your Privacy
Your responses are stored securely and reviewed only by Dr. Wong. Submissions are signed under the federal E-SIGN Act and California UETA, and a record of your signature (with timestamp) is retained.