Admission and Treatment Process

I am asking my future patients to download (click here), complete, and print out the admission forms

and bring a copy of them with them to their first session. This would save time for both patient

and me. Otherwise, they could complete the admission forms in my office waiting area.

I will then complete an initial assessment (psychiatric diagnostic interview). In the case of

adult patients, this would consist of the meeting with the patient and/ or her/his significant other. In

the case of the minor patients, I may need to meet with the patient individually, her/his caregivers

individually, or both of them as a group. This depends on the minor’s chronological and

developmental age among other factors. For patients ages 12 and older, I usually prefer to see them

first individually, then I will see her/his caregivers, and eventually as a group. Although I will try my

best to complete the initial assessment in one session, in some cases this assessment may need to

be completed in 2 sessions for a variety of reasons such as myself or the patient’s time constraints,

incomplete clinical data upon the 1st session or inability to obtain all information needed. The initial

assessment should be ended with our discussion about a summary of what I have

understood from the patient’s current issues, my proposed (working) diagnoses, and the patient’s

treatment options. At this point, I discuss whether or not I think I can provide optimal psychiatric

help to the patient. If both sides agreed that I am the right psychiatrist for the patient, I will enter into

a doctor-patient relationship, and a follow-up appointment will be made. Upon initial assessment and

during my follow-up treatment, I may order routine or non-routine lab tests (including medication

blood levels) or order brain imaging, EEG, and other indicated procedures. I have recently integrated

pharmacogenomic testing into my practice which helps me to choose the best medication regimen

for every individual patient. This is easily done in-office setting by collecting a mouth swab from the

patient. I may also refer the patient to another medical specialist for the purpose of obtaining medical

clearance establishing a baseline medical and metabolic profile, and optimizing medical and

psychiatric care collaboration. If indicated, the patient or her/his caregivers may be asked to fill out different

neuropsychiatric/psychological questioners or rating scales for diagnostic clarification or to monitor the

treatment progress. Psychotropic or PRN medications may be prescribed after having risks/benefit

discussion with the patient. In this case, the efficacy and adverse effects of the medication (s) during

scheduled follow-up visits will be monitored. Upon availability, medication samples could be given. Other

biological treatments such as nasal ketamine administration, ketamine infusion, TMS, ECT, IM injection

of long-acting antipsychotic medications may be indicated, recommended, or performed in-office upon

availability. Referrals may be made to trusted therapists to complement or even substitute medication

management therapy. In some cases referrals to substance abuse treatment programs, rehab facilities,

partial hospitalization programs, inpatient psychiatric hospitals, group homes, assisted living facilities,

nursing homes, hospice, or other higher levels of care may be needed, indicated, recommended, ordered, or

arranged. The Patient’s medical and psychiatric record may be obtained from other previous or current

mental healthcare and medical providers.

Please make sure that you have read and agreed with all the admission forms before signing them. I

am looking forward to seeing you in my practice.

Thank you

Saeed Eshraghi, M.D.