Grayson & Associates

INTAKE FORMS

Consent for Telepsychology

This form is required for updating patient information.

GA Consent for Tele
New-Patient-Form-Newest

New Patient Forms

This form is required to start seeing a Grayson & Associates clinician.

Update to Information Form

This form is required for updating patient information.

84601-Grayson-Info-Update-Sheet-HR
Controlled-Substance-Agreement-1

Patient Controlled Substance Agreement

Release of Information Form

This form is required for sending any medical information from Grayson & Associates to another entity.

Release-of-Info-Updated-11.25.19
Request-For-Medical-Records-new

Request for Medical Records Form

This form is used when you want past medical records from another doctor seen by a Grayson & Associates clinician.

2200 Lakeshore Dr #150, Birmingham, AL 35209
Tel: (205) 871-6926