The following forms must be completed by all new patients:

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• Patient Registration, Client Information Exchange 

• Tucker Psychiatric Clinic Privacy Policy 

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Update forms for existing patients:

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• Patient Registration, Client Information Exchange

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If you need to request records, please fill out this form (if sending to another provider, please include their fax):

• Medical Record Request

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If you need a medication form for school, please fill out this form:

• Medication Form For School

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Additionally, new patients who will see Dr. Jennings will need to complete the following forms:

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• General Information Form 

• Initial Evaluation - Medications List 

• Initial Evaluation - Psychiatric Symptoms Checklists 

• Adult Attention Deficit Disorder Symptoms Checklist 

 

Please remember to bring the completed forms with you when you arrive.