Do you have a Video Appointment with us?

Click Here

Thank you for choosing Brain Wellness Center. Following are the patient forms available online.  


Intake For all  New Patients

This document includes our initial intake, depression and anxiety rating forms.

Please make sure you have looked over the Insurance and Costs section before starting.

 all New Patients please start here 



Weekly Depression & Anxiety Rating Scales (this is for patients receiving TMS or Neurofeedback Therapy)

This document includes our form to assess your weekly Depression and Anxiety.

Weekly Depression & Anxiety Rating Scales




Authorization to Release or Exchange Confidential Medical Information

This document is your permission for us to share your information with someone, or for that person to share their information with us. 

release or Exchange of medical records Authorization



Bipolar Mood Disorder Questionnaire (MDQ)

This document includes our questionnaire to assess Bipolar Mood Disorder.

Bipolar Mood Disorder Questionnaire



Legal Forms We need you to sign before your first appointment 

Click below to access the legal forms we use. These will be required once you are given an appointment or accepted to our practice.




Adult ADHD Self-Report Scale Symptom Checklist

This checklist includes the self-report symptom scale we use in our treatment of Adult ADHD.

Adult ADHD Self-Report Scale Symptom Checklist



List of Medications Taken

This document is for the medications you have taken For new patients, this form is already included in the button above  "All New Patients ....".

List of Medications Taken

Patient Success Stories

"I can't say enough good things about Brain Wellness Center and all their staff! Everyone is super friendly and knowledgeable, and they were able to explain everything to me I'm simple layman's terms… 
Jason J.
"I have struggled with depression my whole life, and for those who also suffer from it, you know It not only affects you, but everyone around you. I had tried multiple medications, but they either we… 
Leonard S.
"Brain Wellness Center changed my life from the beginning. At first I was skeptical just like you all probably are, saying that this procedure would have a decrease or a complete recovery from depres… 
Gianella A.