Cedar Centre Psychiatric Group, LLP
(319) 365-3993


forms



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PLEASE DO NOT USE GOOGLE DOCS, MICROSOFT WORD, OR OPEN OFFICE TO EDIT THESE FILES. ADOBE READER HAS A FREE TOOL "FILL AND SIGN" WHICH WILL ALLOW YOU TO PUT TEXT INTO A PDF WITHOUT CHANGING THE FORMAT. OTHERWISE PLEASE CONTACT THE OFFICE TO HAVE THE PAPERWORK MAILED TO YOU. THANK YOU.


Please be aware that all requests for any paperwork are completed in the order they are received. It can take providers up to two weeks to complete any requested paperwork depending on their schedule and the paperwork requirements. If you have a date that the paperwork must be completed and returned by, please let us know.

Please make sure you have completed all your sections of the paperwork, and have a valid release on file.


You may e-mail these forms to our e-mail drop box. This is for information use only, and not to be used for any medication, therapy or schedule requests. This email is not monitored 24 x 7. Please call the office with any questions. 319-365-3993.


Email: info@cedarcentrepsych.com



Release of Information



CLICK HERE: Please use one release per office or provider, as multiple names on one release will invalidate it.
When filling out a release for any form, paperwork or when you need us to send medical records to another office, please be aware that we have up to 30 days to complete all requests.
If you have a date that your information must be completed by, please include that with your request. BE AWARE, it may still take up to 30 days to complete the request.
When completing our release, please do NOT initial the boxes in the middle unless you do NOT want us to send your Mental Health / Substance Abuse / HIV/AIDS or Genetic Information. If the paperwork requires this information you will delay completion of your request and we will ask you for a new release.



Other Forms



PHI Request

EZ Pay Consent form

TMS Consent form





Cedar Centre Psychiatric Group
(319)365-3993