Our Forms & Policies

If you would like to become a patient, please complete BOTH the Intake Form and Privacy / Consent Form.  We will contact you to schedule your initial appointment upon receipt of these 2 forms. You must complete both forms.

If you inquiring about ADHD or continuing stimulant medication for ADHD, please review and submit our Stimulant Policy.

We accept Blue Cross / Blue Shield and self-pay patients.

Update your Billing and Insurance Information.

Please complete the Release of Protected Healthcare Information Form to authorize Middlesex Psychiatry to speak with a specific person about your care (example: your partner, therapist, primary care provider, or other healthcare professional.)  You may retract a release at any time you choose by requesting to Middlesex Psychiatry that you no longer authorize this individual, hospital, or agency.