Regent Mental Health Group - logo

Madison, WI

Providers

Psychiatrists

Psychologists

Therapists

Physician Assistant

Nurse Practitioner

Resources

(See also: LINKS page)

Forms

Below are links for forms that you can complete and submit securely online (click "submit" at the end of a form when done). Once you submit a form, you will have the option to return here to complete more forms.
[NOTE: If you do not wish to complete forms online, CLICK HERE for versions you can download/print.]

Prospective New Patient Form: CLICK HERE

A. Forms needed annually:

B. Forms to be filled out as needed:

  1. Release of Information Form
  2. Medication Refill Request (when you need us to approve refill at your pharmacy)
  3. Automatic Payment Plan

C. Others forms:

  1. Adult Follow-Up

Patient Education

Resources for Families and Friends