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  • About Us
    • David Meyer, Ph.D.
    • Jonathan M. Borkum, Ph.D.
    • Stacy Whitcomb-Smith, Ph.D.
    • Chantal N. Mihm, Psy.D.
    • Christina Fasse, Psy.D.
    • Melanie Miller, LCPC
    • Mark Kmen, LCSW
    • Laura A. Foster, Ph.D.
    • Rachel E. Goetze, Ph.D.
    • Jeff Matranga, Ph.D., ABPP
    • Directions
  • Treatments and Disorders
    • Pain Management
    • Headaches
    • Biofeedback
    • Anxiety Disorders
    • Panic Disorder
    • Worry - Generalized Anxiety Disorder
    • PTSD & Acute Stress Disorder
    • Obsessive-Compulsive Disorder (OCD)
    • Social Anxiety Disorder
    • Medications or Not?
    • Coping with Cancer
    • Grief Services
  • HIPAA
    • HIPAA Privacy Notice
    • HIPAA Outpatient Therapy Agreement
  • Online Forms
  • Meditation Resources
You are here: Online Forms

Health Psych Maine Online Forms

Forms for All New Clients to Complete

  • Attendance and Cancellation Policy
  • Electronic Communication Policy
  • HIPAA Outpatient Therapy Agreement
  • Release Form
  • Credit Card Authorization Form

Pre-Appointment Questionnaires

You must login before accessing these Pre-Appointment Questionnaires. 
Login to use these forms.

  • Questionnaire for Counseling
  • Headache Questionnaire
  • Pain Questionnaire
  • Coping with Cancer Questionnaire
  • PCL-5 Form
  • Returning Client Questionnaire
  • Headache Retest Questionnaire
  • Pain Retest Questionnaire
  • Counseling Retest Questionnaire
  • Beck Depression Inventory
 
  • Bariatric Presurgery Questionnaire
 

Additional Forms

  • Informed Consent
  • OCI-R

Information

  • Directions

Waterville Location
2 Big Sky Lane
Waterville, ME 04901

 

Bangor Location
(Only for pain management and headache, provided by Dr. Borkum.)
Northeast Pain Management
1365 Broadway
Bangor, ME 04401

 

Phone: 207-872-5800
Fax: 207-872-5888

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