DR. AMANDA TURLINGTON, PSY.D.
MERIDIAN PSYCHOLOGICAL, LLC,
FORMS
REFERRAL FORM
Please use this initial referral form to request services. Submitting a referral form does not guarantee services. However, it does facilitate scheduling, insurance coverage, private pay, etc.
Email draturlington@gmail.com for current intake forms.
INTAKE FORM
Feel free to download Meridian Psychological, LLC, Intake Form. If a minor will be the subject of testing/assessment, the form will need to be completed by the legal guardian. Otherwise, the form will need to be filled out of the subject (or representative) of the testing/assessment.
Email draturlington@gmail.com for current intake forms.
INFORMED CONSENT AND BUSINESS PRACTICES
This form is required to verify your informed consent, outlining Meridian Psychological, LLC, practices. Please email or call with any questions prior to signing.
Email draturlington@gmail.com for current intake forms.
ELECTRONIC COMMUNICATION FORM
This form is required to verify your informed consent, outlining Meridian Psychological, LLC, practices. Please email or call with any questions prior to signing.
Email draturlington@gmail.com for current intake forms.
NOTICE OF PRIVACY PRACTICES
This form is required to verify your informed consent, outlining Meridian Psychological, LLC, practices. HIPAA is a very important component of assessment, including limitations of rights in a forensic setting/referral. Please email or call with any questions prior to signing.
Email draturlington@gmail.com for current intake forms.
OFFICE POLICIES & AGREEMENT
This form is required to verify your informed consent, outlining Meridian Psychological, LLC, practices. HIPAA is a very important component of assessment, including limitations of rights in a forensic setting/referral. Please email or call with any questions prior to signing.
FEE REQUIREMENT
A Statement of Understanding is required. Medicaid may be billed, if pre-authorization is approved by that agency. Private insurance companies are not billed by Meridian Psychological.
Email draturlington@gmail.com for current intake forms.