Welcome to Blue Umbrella Psychiatry! We're here to assist you.

If you're a new patient, please visit our New Patient Page to complete your registration.

However, if you prefer to download the PDF form, you may do so below and email the completed form to office@blueumbrellapsychiatry.com. Once we have received your form, our team will reach out to schedule your appointment. 

On this page, you can find some of the forms that we will need for your first appointment or frequently used forms:

If you have any questions or need assistance, please contact our office at 954‑341‑5215.

Download These:

Child and Adolescent Prescreen

Adult Pre-screening: For any new adult patients including those seeking alternative depression treatments such as TMS.

Adult Prescreen

Forms needed to bring to your first appt: 

• BUP First Visit Form
• BUP Policies and Consents
• BUP Telehealth Consent

Forms frequently used: 

• General Release of Information
• Minor Consent Form
• PHQ-9 Psychiatry Questionnaire
• GAD-7 Psychiatry Questionnaire
• Therapy Consent Questionnaire