Patient Forms

To make the process as smooth and efficient as possible, we provide the most important documents as downloads right here on our website.  When making the appointment ask which forms need to be submitted, select the appropriate download link and return the completed documents to our office, along with an I.D and current insurance card(s), at the time of your appointment. Naturally, all forms are also available at the practice.  However, new patients will need to fill out several forms before the appointment can begin, please come at least 30 mintues before the actual appointment time to ensure your appointment will start on time.  


If you are unsure which forms to fill out, please contact us. Our staff will be happy to help and answer any questions to the best of their ability. 

DISABILITY PAPERWORK

As of December 1st  2022 Dr. Siddiqui will not fill out any Disability /Work Leave paperwork. 

NEW PATIENT PACKETS

Child New Patient Packet (17 & under)
Child New Patient Paperwork 2022.pdf
Adobe Acrobat document [1.3 MB]
Adult New Patient Packet (18 & up)
Adult New Patient Paperwork 2022.pdf
Adobe Acrobat document [1.1 MB]
TeleMed (Video) Consent
TeleMed Consent 2022.pdf
Adobe Acrobat document [523.8 KB]

**If you need a copy of your medical records please fill out the form below and send it back to the office.

Another Facility to BrainDocs
ROI to US.pdf
Adobe Acrobat document [206.0 KB]
BrainDocs to Another Facility
ROI from US (1).pdf
Adobe Acrobat document [203.4 KB]

ADULT TELEHEALTH (18 & UP)

All documents are required to be completed and returned via email or fax, in order to avoid cancellation. 

ADULT OPR (18 & UP)
Adult OPR 2022.pdf
Adobe Acrobat document [1.2 MB]
ADULT PHQ-9
PHQ-9 2022.pdf
Adobe Acrobat document [529.6 KB]
TELEHEALTH CONSENT FORM
TeleMed Consent 2022.pdf
Adobe Acrobat document [523.8 KB]

CHILD TELEHEALTH (17 & UNDER)

All documents are required to be completed and returned via email or fax, in order to avoid cancellation. 

CHILD OPR (17 & UNDER)
Child OPR 2022.pdf
Adobe Acrobat document [781.5 KB]
CHILD PHQ-9
PHQ-9 2022.pdf
Adobe Acrobat document [529.6 KB]
TELEHEALTH CONSENT FORM
TeleMed Consent 2022.pdf
Adobe Acrobat document [523.8 KB]

Children, Adolescent & Adult Psychiatry

 

BrainDocs, PLLC sees patients by appointment only. No walk-ins.

 

Phone: 817-240-0012

Fax: 972-724-2111

 

You may email us at:  braindocs@braindocspllc.net

 

Monday to Friday

9:00 AM to 5:00 PM

 

 

 

 

 

 

 

 

 

 

 

OFFICE CLOSED ON THE FOLLOWING HOLIDAYS:

 

NEW YEARS DAY

MEMORIAL DAY

INDEPENDENCE DAY

LABOR DAY

THANKSGIVING DAY

CHRISTMAS DAY

 

*After each holiday our office resumes as normal the following business day. 

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© BrainDocs PLLC updated 06/18/2019