Our team must collect information about your medical history, insurance plan, and current health condition before beginning the treatment process.
Please download the NEW PATIENT INTAKE FORM above, complete it and email or fax directly to Dr. Mian.
Email: [email protected]
Confidential Fax: 407-960-5635
Also, please include a list of all medication you may be taking or please bring to the appointment. Please also bring any labs that you may have taken. If you have any questions please call Dr. Mian at 407-342-3709.
This relevant information will help us develop your optimal treatment plan. Patients can fill out this information in a “New Patient Information Form” before their appointment. Do not hesitate to seek mental health treatment. Our team is here to help. Call us at 407-588-1744 today to learn more about our services or schedule an appointment.