Consent to Evaluation & Treatment

I request and consent to psychiatric evaluation, diagnosis, treatment planning, medication management, and other behavioral-health services that are within the provider's scope of practice and clinically appropriate.

I understand that treatment may include discussion of symptoms, psychiatric history, medications, substance use, safety, and other relevant health information.

I understand that no treatment outcome can be guaranteed.

I have had an opportunity to ask questions and have received understandable answers.

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