For your initial evaluation appointment:
1) Please arrive 10 minutes early.
2) Below are the forms that you will need to bring in. Completing and submitting the attached forms will enable the staff to prepare a file for the individual seeking treatment in advance and give Dr. Kemp an opportunity to review the person’s chart prior to meeting with him. For the Release of Information form, please sign a form for each party you want Dr. Kemp to collaborate with.
- Adult Intake Form
- Child Adolescent Intake Form-Parent
- Release Of Information
- Privacy Notice
- Patient Registration Form
- Credit Card Payment Form
3) Please call your previous provider and have them send records to our office prior to your first appointment. They may fax the records to 216.292.0627.