Learn more about Nurse Practitioner Shuntak Jerideau

Phone: 817-745-4632

FAX: 1-833-478-1506

  • Home
  • About
  • Resources
  • Insurance
  • Patient Forms
  • Contact
  • Home
  • About
  • Resources
  • Insurance
  • Patient Forms
  • Contact
Make a Payment
Make an Appointment
  • Home
  • About
  • Resources
  • Insurance
  • Patient Forms
  • Contact
  • Home
  • About
  • Resources
  • Insurance
  • Patient Forms
  • Contact
Facebook-f Twitter Youtube Linkedin-in Instagram

Downloadable Forms

  • Financial Responsibility and Consent to Treat Questionnaire
  • Adult ADHD Self Report Scale Questionnaire
  • Anxiety Score GAD-7 Questionnaire
  • Authorization For Release of Confidential Information Questionnaire
  • Child ADD
  • Behavioral Health Tele Questionnaire
  • Controlled Medication Agreement Questionnaire
  • COVID-19 Screening Questionnaire
  • Depression Score PHQ-9 Questionnaire
  • Hospital Consent Questionnaire
  • Informed Consent for Treatment HIPAA Financial and CC Policy
  • MDQ Mood Disorder Questionnaire
  • Medication Consent Psychotropics Questionnaire
  • Mental Health Pre-Screening COVID Screening Questionnaire
  • Request for Records Questionnaire

Have Questions?

Drop us a line and let us know how we can help.

Contact Us

Contact Info

Phone
817-745-4632

Fax
1-833-478-1506

Email
comfortminds1@gmail.com

Our Location

9500 Ray White Road
Suite 200
Fort Worth, TX 76244

Navigation

  • Home
  • About
  • Resources
  • Insurance
  • Patient Forms
  • Contact
  • Home
  • About
  • Resources
  • Insurance
  • Patient Forms
  • Contact
Facebook-f Twitter Youtube Linkedin-in Instagram

© 2024 Comfort Minds & Above Behavioral Health
Powered by Digital Impact