Home
About Me
SERVICES PROVIDED
Integrative Psychiatry
Consultation
Psychotherapy
Psychopharmacology
Addiction Psychiatry
Lyme Psychiatry
Testimonials
The office
HELPFUL FORMS
New Patient Forms
Lyme Forms
Keeping Track of Labs
CONTACT
LINKS & RESOURCES
Dr Marke’s COVID Prevention Protocol
Home
About Me
SERVICES PROVIDED
– Integrative Psychiatry
– Consultation
– Psychotherapy
– Psychopharmacology
– Addiction Psychiatry
– Lyme Psychiatry
Testimonials
The office
HELPFUL FORMS
– New Patient Forms
– Lyme Forms
– Keeping Track of Labs
CONTACT
LINKS & RESOURCES
Dr Marke’s COVID Prevention Protocol
HELPFUL FORMS
Home
HELPFUL FORMS
If you are a new patient, please complete the following forms and bring them to your first appointment.
Registration and Intake Form
Cancelation policy
Privacy Policies
Release of Medical Records Form
Dissociative Experience Scale
If you are a patient with known or suspected Lyme Disease, or with a complex medical issue, please complete:
Lyme Intake and Consent Forms
Lyme Test
Lyme Symptoms List
Keeping Track of Labs: It is most helpful for all patients to gather all lab tests they have had and put them in an easy to interpret form for their doctors. Here are some spread sheets to help you do this:
Blood Count
Blood Chemistries and Routine Panels
Genetic, Thyroid, Gluten
Infectious Diseases and Hormonal Studies
Electro-diagnostic test, MRIs, CTs, biopsies
Medications
Supplements
Antibiotic Spreadsheet for tracking
Lyme Test
Please compete the spreadsheets listed above