Patient Forms

Thank you for selecting Neuro Behavioral Center for your needs. Our practice is a leader in providing adult psychiatric and psychology services. We are conveniently located in Walpole, Massachusetts, offering easy access to our caring providers, a friendly staff, and fast access to book appointments.

Patient Registration Forms

Neuro Behavioral Center in Walpole, Massachusetts welcomes you to our practice. Once you have made your initial appointment,  you may download and print the form(s), fill them out, and bring them with you to your first visit. Completing the forms prior to your visit will help speed up the new patient registration process.

Also, be sure to bring any diagnostic films or other test results that may have been ordered or performed by another physician.

Downloadable Forms:

• Notice of Privacy Practices
• Acknowledgement of Receipt of Notice of Privacy Practices
• Authorization for Release/Obtain Exchange of Patient Medical Record Information
• Patient Emergency Contact Form
• Patient Treatment Agreement
• Tele-Psych Contract & Informed Consent

Please note:  It may take a few moments to load the forms if you are using a slow internet connection. If you are unable to view the forms, you may need to download Adobe Acrobat Reader for free by clicking on the icon below.