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) |
| 2. Registration Form for Dependent (required for dependent patients) |
| 3. Secondary Insurance |
| 4. Consent for Verbal Communications (required) |
| 5. Receipt of Privacy Practices (required) |
| 6. Office Privacy Practices (information only) |
| 7. Release of Medical Information |
| 8. Credit Card Authorization Form |
| 9. Medicare Private Contract (required for patients with Medicare) |