Registration Forms, Privacy Policies and Release of Information Permissions
You are encouraged to complete the registration form and bring to your first visit, or you may send them to us by fax or email. (fax: (760) 723-7872; email: fallbrookpsychiatry@gmail.com)
COVID-19: During the corona virus pandemic, Dr. Murphy encourages patients to have their appointments by telehealth. This may be done on a mobile phone, or on a computer that has a camera. Make sure your camera and microphone are enabled and paste the following link onto your browser: https://doxy.me/timmurphymd (or click on this LINK now)

1. New Patient Registration Form (required for new patients) | |
File Size: | 46 kb |
File Type: |

2. Registration Form for Dependent (required for dependent patients) | |
File Size: | 55 kb |
File Type: |

3. Secondary Insurance | |
File Size: | 30 kb |
File Type: |

4. Consent for Verbal Communications (required) | |
File Size: | 505 kb |
File Type: |

5. Receipt of Privacy Practices (required) | |
File Size: | 170 kb |
File Type: |

6. Office Privacy Practices (information only) | |
File Size: | 122 kb |
File Type: |

7. Release of Medical Information | |
File Size: | 102 kb |
File Type: |

8. Credit Card Authorization Form | |
File Size: | 149 kb |
File Type: |

9. Medicare Private Contract (required for patients with Medicare) | |
File Size: | 186 kb |
File Type: |