We know that it can be a bit tiring or stressful filling out all of the necessary information upon your initial visit. To make this process easier on you, we’ve converted our TMS registration form, as well as other common forms, into PDF files which allow you to download, print, and complete them at home. Please reference the buttons below or quick links to download our forms. Complete them on your own time and bring them with you if you’d like to save time during your visit.
Our TMS Registration Form pdf is based on the same information that will be required on your insurance’s prior authorization form. While we understand no one enjoys filling out these types of forms, we ask that you please be as thorough as possible.
This form is used to authorize select health care or pharmacy providers to use or disclose specific information to RDT Advanced Wellness Center for the purpose of receiving TMS therapy and to obtain prior authorization for TMS treatment services.
The privacy of your personal health information is very important to us. We will maintain the privacy of your health information and will not disclose your information to individuals or a 3rd party without your permission unless the law requires us to do so.
Please complete the following pdf form prior to the start of your TMS treatment. If you have selected any of the boxes under the Contraindicated Section, then TMS therapy is contraindicated, and therefore, would not be a viable treatment option for you.
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The following pdf contains a list of common medications that are used to treat depression. If you have brought a medication list or had your records sent from your physician’s office, please fill out this form and bring those documents to your consultation.Â
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You can use the PHQ-9 and GAD-7 to screen for depression, as well as measure the level of symptom severity in people with depression. Both the PHQ-9 and GAD-7 can be used for other anxiety disorders such as phobias and generalized anxiety disorder.
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RDT Advanced Wellness Center recommends that our patients wear ear plugs during TMS therapy treatment to protect their hearing. If you choose not wear hearing protection you will be required to complete the following hearing protection waiver form.
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