Services rendered include psychiatric evaluation and medication management. As with all aspects of medical care, no guarantee can or will be made concerning the outcome of any evaluation or treatment.
In order to provide treatment for you or your family member, the provider must obtain your consent. By signing this consent form, you authorize your provider to treat you (or the patient, if you are the parent/guardian) to provide all evalations or treatments that the provider determines to be necessary or recommended.
This document will be considered your consent to all services provided in connection with this visit and all visits at Pinnacle Behavioral Health IPA, LLC unless you revoke your consent, which you may do at any time.
You will be informed of the benefits, risks and alternatives regarding treatment. At any time, you may request and will receive a more detailed explanation. At any stage of your outpatient visits here, you may revoke this consent or refuse treatment.
By signing this consent, you acknowledge that you have read it or that it has been read to you, that you are at least 18 years of age, and that you are signing voluntarily.
Additionally, it is important to be aware that your provider does not treat patients on an in-patient basis. In the event that a patient requires psychiatric hospitalization, they will be referred to an appropriate hospital and will be cared for by another psychiatrist during the hospitalization.