Patient Forms


 

Our office hours are Monday-Friday 8:30 am to 5:00 pm. Please call Revîv Psychiatry at 714-871-9357 to speak about scheduling an appointment or click 'Book Online' at the top of the webpage to request an appointment online.

PLEASE BE AWARE we will still need to confirm your appointment BY PHONE. So, if you are booking online or leaving a voicemail please provide a phone number where you can be reached to confirm your appointment. We will call you back within 1-2 business days.

Also, if you are calling on behalf of someone please be aware that we still need to speak to THE PATIENT SEEKING TREATMENT to confirm the appointment. We would also like to remind you that Revîv Psychiatry is an adult clinic serving patients ages 18 to 72.

Once your evaluation appointment has been confirmed, you will be sent the required pre-appointment forms. These forms MUST be completed at least 48 hrs before your scheduled evaluation appointment. If your appointment is via telemedicine our office staff will give you instructions on how to join. If your appointment is in office, we recommend that you arrive 10 minutes early.


What you need to know for your first appointment: 

1. Please complete the new patient forms below PRIOR to booking your first appointment by clicking each red hyperlink. You will be directed to a page that will ask for your name and email. No password or username is needed.

2. Your payment will be due at the time of service. We accept cash, check, and card.

3. If you need to cancel your appointment please provide a 24 hr notice so that we may offer this appointment time to someone else in need & so that you can avoid the cancelation fee. The cancelation fee is half the cost of your total visit

4. If your appointment is in office, please arrive a minimum of 10 minutes early.

If you would like Revîv Psychiatry to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize the release of psychotherapy information: