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  • About
    • Non-Disclosure
    • New Patient Information
    • No Cost Programs
    • Patient Feedback
  • Our Services
    • General Medicine
    • Pediatrics
    • Reproductive Health
    • Geriatric Care
    • Dermatology
    • Orthopedics
    • Weight Management
    • Urgent Care
    • Employer Services
    • Nursing Home & Assisted Living Services
  • Patients
    • Patient Forms
    • Medication Pricing
    • Patient Portal
    • Sliding Scale Application
    • Billing & FAQ
    • Prescription Assistance
    • Order Supplements
  • Mental Health
    • ADD/ADHD Treatment
    • Addiction
    • Anxiety
    • Assessments
    • Athletes
    • Counseling Services
    • Counselors
    • Court Mandated Therapy
    • Depression
    • Eating Disorders
    • Evidence-Based Therapy Practices
    • Family and Children
    • Groups and Classes
  • The YFMC Blog
  • Locations
    • Cape Girardeau
    • Perryville
Menu
  • About
    • Non-Disclosure
    • New Patient Information
    • No Cost Programs
    • Patient Feedback
  • Our Services
    • General Medicine
    • Pediatrics
    • Reproductive Health
    • Geriatric Care
    • Dermatology
    • Orthopedics
    • Weight Management
    • Urgent Care
    • Employer Services
    • Nursing Home & Assisted Living Services
  • Patients
    • Patient Forms
    • Medication Pricing
    • Patient Portal
    • Sliding Scale Application
    • Billing & FAQ
    • Prescription Assistance
    • Order Supplements
  • Mental Health
    • ADD/ADHD Treatment
    • Addiction
    • Anxiety
    • Assessments
    • Athletes
    • Counseling Services
    • Counselors
    • Court Mandated Therapy
    • Depression
    • Eating Disorders
    • Evidence-Based Therapy Practices
    • Family and Children
    • Groups and Classes
  • The YFMC Blog
  • Locations
    • Cape Girardeau
    • Perryville
Schedule Appointment

Patient Forms

Mental Health

  • Adolescent PHQ 9 – Assess the Degree of Depression Self-Assessment
  • Adult PHQ 9 – Assess the Degree of Depression Self-Assessment
  • Generalized Anxiety Disorder GAD7 – Anxiety Self-Assessment
  • Beck’s Depression – Depression Self-Assessment
  • Adult ADD/ADHD – ADD/ADHD Self-Assessment
 

Primary Care

  • New Patient Registration Packet – This packet contains all the forms below and everything we need to register you as a new patient
  • HIPAA & Consent – Consent to treat you and our HIPAA policy
  • Medical Records Release – If you need to release medical records to us from another facility
  • Cancellation Policy – Our policy with regard to canceling an appointment
  • Medication List – List of all of the medications you are currently taking

Now Offering Online Supplements!

Through our partnership with WholeScripts, we now offer a simple and affordable way to order the supplement you need online. Create an account and start shopping today!
Order Supplements Online
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About Us

View Our Locations
Cape Girardeau
Perryville
Read our Blog
View Patient Feedback
No Cost Programs
Medication Pricing

Our Services

General Medicine
Pediatrics
Reproductive Health
Geriatric Care
Dermatology
Orthopedics
Mental Health
Weight Management
Urgent Care
Employer Services
Nursing Home & Assisted Living Services

Patient Information

Patient Portal
Request an Appointment
Billing Info & FAQ
New Patient Information
Prescription Assistance
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