Patient Forms

Patient Forms

Become A Patient

Return the completed form by email: info@integratedpsychiatric.com or via secure fax (617) 250-8262.


Patients who are currently hospitalized or discharged from an acute care setting within the past 30 days receive PRIORITY consideration.​


Please email or fax medical records such as neuropsychological evaluations, hospital records, and clinical progress notes along with the completed intake form.

Intake Form

Refer a Patient

Return the completed referral form by email: info@integratedpsychiatric.com or via secure fax (617) 250-8262.

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Please attach any recent progress notes or medical records in addition to any other pertinent information along with the referral form. 

Patients who are currently hospitalized or recently discharged from an acute care setting within the past 30 days receive PRIORITY consideration to ensure continuity of care.


if you do not receive a callback within 2 business days, please call and ask to speak with our practice manager, Laura Colleton at (781) 996-0046 to confirm that we received the paperwork.

Referral Form
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