NEW PATIENT INFORMATION

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The first step in that process is completing our New Patient Form. This secure, online form asks a variety of questions, from contact information to personal medical history. Please try to answer all questions as thoroughly as possible, as it will help in the development of your care plan. Once this is completed, please fill out the other forms on this page prior to your first appointment.

At Golden Mean Health, we’re committed to providing compassionate, evidence-based care that emphasizes harmony and balance. That means getting to know our patients — and knowing them well.

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NEW PATIENT FORM FOR
Jennifer Humphreys DNP, FNP-C, PMHNP-BC

NEW PATIENT FORM FOR
Julie Frederiksen, PMHNP-BC, FNP-BC

PATIENT
FORMS

PATIENT EXPECTIATIONS

INSURANCE INFORMATION

HIPAA Consent FORM

Patient Health Questionnaire

PATIENT FORMS FOR
JULIE FREDERIKSEN, FNP-BC, PMHNP-BC

To make your patient experience as easy and convenient as possible, most forms and documents, including Consent to Treat, are available electronically. Please be sure to fill out all of the below forms before your first appointment. If you have trouble filling out these forms electronically please arrive 30 minutes prior to your appointment. 

PATIENT FORMS

PATIENT EXPECTIATIONS

INSURANCE INFORMATION

HIPAA CONSENT FORM

Patient Health Questionnaire

PATIENT FORMS FOR
Jennifer Humphreys, DNP, FNP-C, PMHNP