Susan K. Wynne, MD - Psychiatry in San Antonio, Kerrville, Fredericksburg - Child, Adolescent and Adult Psychiatrist

Patient Forms

We require that you call us one (1) to two (2) business days prior to your first appointment and one (1) to two (2) business days prior to subsequent appointments, so that we can confirm your appointment.  For example, for an appointment scheduled on Monday, we require confirmation of your appointment before close of business on Friday. 

As a courtesy, we will call you at least one (1)  business day prior to a scheduled appointment.  Please provide us with phone numbers so we may easily reach you during the business day.  We must receive confirmation from you by telephone one (1) to two (2) business days prior to your scheduled appointment.  If we do not receive confirmation from you one (1) to two (2) business days prior to your scheduled appointment, we cannot guarantee that your appointment time will be available.  Thank you.

1. Please complete individual Release of Healthcare Information forms for:

a.) Primary Care Physician;
b.) Psychotherapist;
c.) Past Psychiatrist and/or Psychotherapist.

Download: Release of Healthcare Information - (Word Document Word Document - 24KB)

2. Please read, sign and date the Psychiatrist-Patient Services Agreement

Download: Psychiatrist-Patient Services Agreement - (Word Document Word Document - 36KB)

3. Please complete the Patient Information form. 

Download: Patient Information - (Word Document Word Document - 29KB)

 

Dr. Susan K. Wynne, MD. is Board Certified in Child, Adolescent and Adult Psychiatry