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Menu
  • Home
    • COVID-19 Safety
  • About Us
    • Our Doctors, Physician Assistants, and Nurses
    • Our Team Approach
    • Our Office
  • Services
    • Group Therapy
  • Patient Info
    • First Visit
    • Forms
    • FAQ
  • Pricing
  • Podcasts
    • Apple
    • Spotify
  • Contact Us
  • Apply Here
CALL TODAY
516-506-1900
CALL TODAY 516-506-1900

Forms

Please complete and bring the forms in to your initial evaluation or email them to office@centerhealthyminds.net .

Teleconferencing Form
Patient Information - Child
Patient Information - Adult
Consent for Treatment
Payment Policy
Reminder Calls
Policies and Procedures
HIPAA Consent
Cardiovascular Screen
Prospective Patient Questionnaire
The Center For Healthy Minds
Dr. Halana Rothbort

222 Rockaway Turnpike, Suite 1
Cedarhurst , NY 11516

(516) 506-1900

Contact Us

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