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Holding Tablet Computer

Patient
Electronic Forms

All forms are electronic, you may complete on a computer, tablet or smart phone. 

All new patients must complete a "New Patient Packet". This is required prior to your first appointment.

 

The "New Patient Packet" consists of 3 separate sections:

  1. New Patient Information

  2. Insurance form (picture submission)

  3. New Patient Assessments

 

Once you complete section 1, you will be directed to section 2, and then section 3. Should you close your browser after section 1, you may use the links above to get to the others.  

 

To complete this form you will need:

  • Insurance card

  • Medication list

  • Allow 20-25 minutes to complete all 3 sections

  • All new patients 

OR

  • Established patients who have changed insurance

Any patient who would like to add a family member, friend, therapist, etc to allow communication with our practice/providers.

  • Obtain records from another entity (clinic, hospital)

OR

  • Release records from Raleigh Wellness Behavioral health to another entity (clinic, hospital)

Complete this form to authorize our practice/providers to appeal for medication prior authorizations on your behalf.​

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