BOOK AN
APPOINTMENT
CALL
TEXT
Home
About Us
What We Do
Providers
Careers
Professionals & Careers
Employment Inquiry
Referrals
Make a Referral
Links To Other Providers
Join our Referral Network
Request Records
Email A Provider
Rating Scales
Carlat Psychiatry Podcast
Patients
Patient Portal
Request Portal Access
Med Refills
Recommended Products
Labs
Billing
Patient Guides
Antidepressant Lifestyle
Sleep
Depression and Bipolar Workbook
Treatment Guides
Rating Scales
Referrals To Other Practices
Help in a Crisis
Services
New Clients
Request First Visit
Request TMS
Refer A Client
Counseling & Therapy
Counseling
Addictions
Group Therapy
DBT Therapy
Medication & TMS
Medication
TMS for Depression
Genetic testing
Athelas Home Labs
Natural Therapy
Children, Teens, and Families
Forms
All Forms
Therapy Visit Form
Med Visit Form
Agreement to Treatment
Telehealth Client Consent & Agreement
Controlled Substance Agreement
Records
Records Reuqest
Send Records to Us
Other
Legal Services
Family Involvement
Input From Friends & Relatives
Release of Information
Disability
Update Demographics
Pay Bill
From the Dr
Books
Audio book
Podcast
Pocket Psychiatrist (for patients)
Carlat Psychiatry (for professionals)
Psych Education
PsychTimes Articles
Webinars
Blog
Contact Us
Email, Phone, Text
Feedback and Comments
Input from Friends & Relatives
Emergency Line for Current Clients
REQUEST FIRST VISIT
PATIENT PORTAL
✕
Forms
Forms
NEW PATIENT FORM
Emergencies
Our emergency line, (336)-525-9090, is staffed 24/7 for current clients.
Treatment Agreement Form
Agreement to treatment with Mood Treatment Center
Controlled Substance Agreement
Med Visit Form
Complete before your visit. Or use printable version.
Med Visit Form (Child)
To complete before medication visits.
Therapy Visit Form
To complete before therapy appointments.
Teletherapy Consent Form
Agreement to therapy/counseling through telehealth
Disability
Request disability or FMLA forms.
Legal services
For clients who need us to provide testimony or consultation for legal purposes.
Release of Information
Authorize us to communicate with others on your behalf.
Request our records
Release our records to other parties.
Send records to us
Request that outside providers send records to us or communicate with us.
Pay bill
Update Demographics
Authorize us to communicate with your family or friends.
Feedback and Comments
Let us know how we can improve our services.
