Paperwork to Complete
Prior to Your
Credit Card Payment
Paperwork to Complete Prior to Your First Visit
Some initial paperwork is
necessary before we can begin services. We will have more time to
discuss the issues for which you are seeking assistance if you review
and complete the required forms in advance. If you have any
questions about the paperwork, feel free to to discuss them with me
when we meet. Please print the relevant forms, complete them, and
bring them to your first appointment. The forms are in PDF format.
Click on the
icon to the left to download a free copy of Adobe Reader.
1. Initial Paperwork
2. United Behavioral
Health Adult Wellness Assessment
NOTE TO CLIENTS COVERED BY UNITED BEHAVIORAL HEALTH:
As of December 1, 2005, UBH is requesting (not requiring) that clients
complete a Wellness Assessment for the initial visit. If you have
concerns about completing this form, please discuss them with me or
with a UBH representative available at the number on the back of your
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Credit Card Payment
For your convenience, payment for
bills over $50 can be rendered securely online. Please
note that you must sign a payment consent form in my office prior to
using this service.
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accuracy of health information obtained from the Internet cannot be
guaranteed. You are advised to make health decisions in
consultation with your healthcare professional.
American Council on Exercise
The ACE Web Site is a resource for people interested in information
about safe and effective exercise. More than 80 different editions of
ACE Fit Facts are available free to the public. Clear, concise,
one-page fact sheets covering a multitude of fitness issues, ACE Fit
Facts are distributed through our Web Site, via Fax on Demand and
through hundreds of health fairs and community events throughout the
American Diabetes Association
The American Diabetes Association is the nation's leading nonprofit
health organization providing diabetes research, information and
advocacy. The mission of the organization is to prevent and cure
diabetes and to improve the lives of all people affected by diabetes.
To fulfill this mission, the American Diabetes Association funds
research, publishes scientific findings, provides information and other
services to people with diabetes, their families, health care
professionals and the public. The Association is also actively involved
in advocating for scientific research and for the rights of people with
American Fertility Association (AFA) and works to transform the lives
of couples faced with infertility, raise awareness and fight for social
and legislative change around infertility issues. The AFA's
purpose is to educate the public about reproductive disease, and
support families during struggles with infertility and adoption. The
AFA exists to serve the unique needs of men and women confronting
American Heart Association
The American Heart Association is a national
voluntary health agency whose mission is to reduce disability and death
from cardiovascular diseases and stroke.
American Psychological Association
The American Psychological Association is the
world's largest organization of psychologists. Useful information
about coping with life's problems can be found at the Consumer Help Center.
American Society for Reproductive Medicine
ASRM is an organization devoted to advancing
knowledge and expertise in infertility, reproductive medicine and
biology. ASRM Resources for Patients provides information
on infertility, menopause, contraception, reproductive surgery,
endometriosis, and other reproductive disorders. There is also a
page addressing frequently asked questions about the Psychological
Component of Infertility.
Brain Injury Association of America
Injury Association of America was founded in 1980 by a group of
individuals who wanted to improve the quality of life for their family
members who had sustained brain injuries. Despite phenomenal growth
over the past two decades, the Association remains committed to its
grassroots. The Brain Injury Association of America encompasses a
national network of more than 40 chartered state affiliates across the
country, as well as hundreds of local chapters and support
groups. The San Antonio chapter is the Alamo Head
Healthfinder® is an award-winning Federal Web
site, developed by the U.S. Department of Health and Human Services
together with other Federal agencies. Since 1997, healthfinder® has
been recognized as a key resource for finding the best government and
nonprofit health and human services information on the Internet.
healthfinder® links to carefully selected information and Web sites
from over 1,800 health-related organizations.
National Cancer Institute
The National Cancer Institute coordinates the National Cancer Program,
which conducts and supports research, training, health information
dissemination, and other programs with respect to the cause, diagnosis,
prevention, and treatment of cancer, rehabilitation from cancer, and
the continuing care of cancer patients and the families of cancer
Rehabilitation Information Center for Independence
NARIC is committed to providing direct, personal, and high-quality
information services to anyone interested in disability and
rehabilitation issues. NARIC's Instant Disability
Information Center allows you to search a huge collection of
federally funded research projects, books, and articles.
This site has information and tools for improving your health.
There is also information on various medical issues and guides to help
you make decisions about your treatment, from one of the premier
medical centers in the world.
This is the USDA website that provides detailed information about the
government's new food pyramid that incorporates exercise and individual
caloric needs. The food pyramid was changed in response to the
government's concern regarding the increasing weight of Americans.
Resolve: The National Infertility Association
Resolve is The National Infertility Association and
has a nationwide network of chapters. It is a dynamic
organization dedicated to providing advocacy, education, and support
for men and women facing the crisis of infertility. The South
Texas chapter (http://www.resolveofsouthtexas.org) serves the San
Spine-health.com was developed by a group of
medical professionals and aims to provide comprehensive, highly
informative and useful resource for understanding, preventing, and
seeking appropriate treatment for back and neck pain and related
USDA Center for Nutrition Policy and Promotion
The Center for Nutrition Policy and Promotion was
created in the U.S. Department of Agriculture, December 1, 1994, and is
the focal point within USDA where scientific research is linked with
the nutritional needs of the American public.
The creation of the Center comes at a time when the American public is
increasingly aware of the importance of diet, yet is receiving
conflicting nutrition messages. The Center, therefore, will serve as a
touchstone where the public is assured that the nutrition guidance they
receive is based on sound research and analysis.
© Copyright 2006 Poonam
Sharma, Ph.D. All Rights Reserved.
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