Gwinnett Psychiatry, PC

170 Camden Hill Road, Suite F

Lawrenceville, GA 30046

Phone: (678)226-2295

www.gwinnettpsychiatry.com

Fax: (678) 226-2296

Terms and Conditions for Office & Tele-Medicine VISIT

To ensure the safety and privacy of our patients, we are updating our policies:

Patient required to return the "New Patient Paperwork", along with the governmental picture ID and the picture of Insurance card (Front & Back), both picture ID and Insurance card must be emailed to the email address listed on the bottom of the last page of this paperwork. The rest of the paperwork can be sent to us by EMAIL/FAX/US MAIL. Once we receive the entire paperwork, we will call you to schedule.

As for SELF PAY Patients, only picture ID is required

Picture(s) of the paperwork is not ACCEPTED

Two sided print out not accepted as well

Patient must be present for every visit/session (insurance requirement)

Patient(s) can NOT be in a public place. Its recommended that the patient be in a private place during the session to ensure the privacy and comfort.

Patient must be properly dressed

Patient(s) under the age of 17 must be accompanied with a parent/guardian. The parent/guardian must be on the patient(s) registration forms.

Patient can NOT be driving or in a moving vehicle

If these conditions are not met, the patient(s) will have to reschedule his/her appointment(s) for another day when the above requirements can be met. We can provide a work/school excuses and fax or email it if necessary. Please make sure prior to your appointment that you have a good WIFI/Internet connection and your device is set to access your camera and microphone.

Please keep in mind that there is a $50 no-show fee for each missed appointment, cancelled within 24 hours. Please be prepared to pay any co-pay and balance before the appointment. Please check our website for more information at www.gwinnettpsychiatry.com.