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Texas Psychiatry Associates
HIPAA
Compliance
1
Current State Of Residence?
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Texas
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2
Are Any Of The Following Symptoms Present?
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Sadness
Low energy & motivation
Poor concentration
Appetite changes
Irritability
Trouble sleeping
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3
Has There Been A Clinical Diagnosis Of Depression?
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No
I'm not sure
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4
How Many Anti-Depressants Have Been Tried?
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0
1
2
3+
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5
Select Current Insurance Coverage
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Private insurance
Employer-provided insurance
Medicare
Medicaid (not covered)
None. I plan to pay myself
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6
What Day Is Best For The Consultation?
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Monday
Tuesday
Wednesday
Thursday
Friday
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7
Any Questions About TMS Therapy?
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Is TMS right for me?
How many sessions will I need?
Will my insurance cover it?
Will it help my anxiety?
Is there any discomfort?
Other
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8
Can We Get A Name?
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First Name
Last Name
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9
Where Can We Send More Information?
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10
Please Verify Your Cell Phone Number
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