PHYSICIAN REFERRAL

Patient Referral information form

PATIENT AUTHORIZATION

Authorization to release patient health information

NEW PATIENT FORMS

Forms New Patient Forms must be completed before your first appointment. If completing the forms prior to your arrival, do not sign or initial any of the documents – Signatures must be witnessed in our office.

FORMS FOR DR. CRISLER

Forms to be completed by all new patients of Dr. Crisler who are under the age of 18. Please have all questions answered prior to first visit with Dr. Crisler. The forms can be mailed to us at 4800 Whitesport Circle, Ste 2, Huntsville, AL 35801, emailed to Dr. Crisler at mcrisler@alapsych.com, or faxed to our office at 256-533-9690.