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Practice Forms
1. Welcome Letter 2. Notice of Privacy Practices for Protected Health Information 3. Acknowledgement of Receipt of Notice of Privacy Practices 4. Release of Protected Health Information Form (Clinical and Forensic versions) 5. New Patient Registration Form 6. General Practice Policies and Financial Disclosures 7. Sample Invoice Receipt 8. Initial Consult Form Insurance Patients may submit their invoices to their insurance company to receive reimbursement for treatment provided by Dr. Simopoulos. Please contact Dr. Simopoulos if you would like more information about fees and billing. |
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- Home
- About Dr. Simopoulos
- Curriculum Vitae
- Practice Locations
- Practice Forms/Insurance
- Dr. Simopoulos Video Lecture: Western State Hospital, Staunton, VA, March 5, 2014
- Dr. Simopoulos Video Lecture: Western State Hospital, Staunton, VA, July 16, 2014
- Dr. Simopoulos Video Lecture: Western State Hospital, Staunton, VA, December 17, 2014
- Dr. Simopoulos Video Lecture: Western State Hospital, Staunton, VA, January 6, 2016
- Other Recent Lectures
- Institute of Law, Psychiatry and Public Policy
- American Academy of Psychiatry and the Law
- American Psychiatric Association
- Psychiatric Society of Virginia
- Association for Psychiatrists in Washington, D.C.
- Mental Health Blogs