Current Environment: Development

Dev

Behavioral health documents

Please complete the form(s) requested by your provider and submit them via MyChart.

To submit:

  • Reply to the original MyChart message you received.
  • Click blue button that says “attach image or video.”
  • Upload all document you want to send in your reply

If you are unable to upload the forms via MyChart, please email the completed forms to pnw.secure@pedinw.org and also send a MyChart message letting us know that you submitted the forms through email.

Initial intake paperwork

Followup paperwork