Patient Information

New Patient Intake Paperwork

Please provide your detailed information to expedite access to the patient online portal. Prior to the appointment, please take a moment to complete the new intake paperwork. As soon as you confirm the appointment, an invite will be sent to your email to register on the patient portal.

Please follow the instructions below:

1. Please sign all forms under the forms section. Most especially the consent for treatment via telehealth form.
2. In the uploads section, upload the front copies of your ID and health insurance cards. Click on the profile tab, under the patient information, complete the current information and the patient history tab. In the patient history tab, complete all sections

All of these must be submitted at least 48 business hours before your appointment. If you cannot see the Patient Portal email, or is struggling to sign the consent forms, please send us an email to info@amplegracepsych.com for assistance.

How It Works

Once you booked an appointment, you will receive an email for your Patient Portal and insurance coverage, if you will pay through insurance, after 24 hours.

If you booked an ADHD testing or Adult Autism appointment, we will also send you the required assessments that are needed for your appointment.

FOR ADHD TESTING PATIENTS: Please take note that if you are currently taking any stimulants and are in Minnesota, you don’t have to do the Qb tech assessment. Send us an email with your current medications to confirm.

You will then receive a telehealth link for your appointment. This telehealth link is permanent and will be used for your future appointments, so bookmark or save it.

To open the visit, you can click the text link from your computer or phone. If you are using your smartphone, you will be prompted to download the free Zoom meeting conference app. This will open up the visit where we will be face-to-face.

If you have any difficulty, just let us know. We can directly text you the link to click on at the time of our appointment and we can begin.

No Show and Late Cancellation Policy

New patients who do not complete their registration and Intake Forms 48-business hours before their appointment will have to reschedule their appointment. This allows the provider ample time to review your case prior to your appointment.

Due to high demand for services, it is important that patient’s honor the time reserved for their appointment. Therefore, appointments canceled less than 48 -business hours will be charged.

• – $100 No Show Fee: Initial Appointment
• – $50 No Show Fee- Follow-up Appointment

Failure to complete the new intake paperwork and then showing up for appointment, you will be charged full fee and the service you paid for will be forfeited as appointment cannot be done without the new intake paperwork.