Please list ALL prescription medications you take, including dosage also include dosages and the number of times daily *

Telehealth consent form

Name: *

Intake Form

If you're interested in a consultation, please complete the form below. To protect confidentiality, you may just submit your first name but I will need an email address or phone number to contact you. You may also schedule an appointment through the scheduling link below. Please make sure to print out and complete the clinic policy, and intake form and bring them to the first appointment, if this is not done there will be less time available for your care.

Due to their potential side effects, I take a conservative approach to prescribing benzodiazepines (Valium, Klonopin, Xanax), I have found that therapy along with other anxiolytic medications are a safer and more effective approach in the long term for the treatment of anxiety disorders.

At this office Dr. Shuman does not bill insurance directly. Payment is due when you reserve an appointment service. You may afterwards be eligible for reimbursement from your insurance company, but only you can determine if you have coverage for care. If there are questions about benefits, please contact your insurance company prior to scheduling an appointment. Dr. Shuman does not bill Medicaid or Medicare at this location.

A typical hour long evaluation is $320, 25 minute follow up visits are typically $160.

An initial comprehensive evaluation for ketamine including the first treatment is 360$, follow up treatments are 250$.

Fees will be discussed with you before you schedule and pay for an appointment. Court - ordered evaluations, expert witness testimony, or evaluations required by any regulatory body, are priced individually. Payment can be made by cash, Discover, Visa, and MasterCard.

Submitting this form does NOT establish a physician - patient relationship. A physician - patient relationship is only formed after a formal assessment during which we discuss diagnosis, treatment, and recommendations which are then implemented.

Make sure to print and complete the privacy policy, clinic policy, and intake form and bring them to your first appointment, if this is not done there will be less time available for your care.

Phone

Psychiatrist in Denver

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yes

An email address or phone number is necessary so I can contact you. Did you enter an email address or phone number? *

Yes

I have read, understand, and agree with all of the above. *

I Agree

Psychiatric and Addiction Treatment

What's the problem you want to change? For example, addiction, anxiety, depression. *

Our Location

Psychiatrist in Denver

PHONE 303-870-8331

FAX 720-489-3876

600 North Grant St. #815 Denver CO 80203