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Northland Psychiatric Specialists Patients Center

Online Enrollment Packet
Save time in the waiting room by filling out our new patient forms online. We suggest that once you finish filling out the online forms, email, fax, or print out a copy to bring to your appointment. We look forward to meeting you! We will confirm your email request within 24 hours.

Directions:
Once you complete a form, make sure to only hit the 'submit' button once. If you are using Microsoft Outlook to send and recieve your mail, once you hit 'submit' - the form will attach itself to an outgoing email message addressed to NPSKC.

If you are NOT using Microsoft Outlook and are using an email address such as Yahoo, Gmail or Hotmail, once you complete the form and hit 'submit' - you will be prompted to save the PDF. Once you save the form, email it to us at info@npskc.com.

Get Adobe Reader
Adobe Reader must be installed to fill out these forms online.
New Patient Self Referral Form
Request an Appointment
New Patient Self Referral Form
Child and Adolescent Form
New Patient Self Referral Form
Change of Information Form
New Patient Instructions
New Patient Enrollment Packet
New Patient Instructions
Authorization to Release Confidential Healthcare Information
New Patient Instructions
Authorization to Receive Confidential Healthcare Information
Hours of Operation: Monday - Thursday 8am-5pm
Closed for Lunch: 12pm-1pm
Phone: 816-453-6777
~ DIRECTIONS TO OUR OFFICE ~
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