Serene Minds LLC

Wilmington DE and Newark DE Psychiatrists Specializing in Cognitive Behavioral Therapy, Electroconvulsive therapy, Transcranial Magnetic Stimulation, Eye movement desensitization and reprocessing, Play Therapy, Post-traumatic Stress Disorder, and Depression

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TMS
Spravato®
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Patient Portal

Patient Forms

For New Clients:

Client Information Sheet
Guidelines
Adult Client History Form
Medication Management_Patient Agreement (for Medication Management Clients only)
Release of Information (ROI) Authorization
Adverse Childhood Experiences (ACEs) Questionnaire for Adults (For clients age 18 and over only)
Parental consent form for treatment of minors (For clients age 17 and under only)
Telehealth consent form
PHQ-9 and GAD-7 form

For Existing Clients:

Client Information Update Sheet (for changes in any client information such as address or insurance(s))

For Clients Reference:

Patient Portal Set-up Process
HIPAA Notice of Privacy Practices

Online PHQ-9 form

Online PHQ-9 form

Online GAD-7 form

Online GAD-7 form

Request an Appointment

You can also schedule directly by calling (302)478-6199 during normal business hours. If this is an emergency, please call 911.

Name*
First Last
Age*
Please enter a number from 1 to 125.
Email*
Phone*
Type of service requested (choose all that apply)*
- Medication managment
- Talk Therapy
- Transcranial Magnetic Stimulation
Note: TMS refers to Transcranial Magnetic Stimulation
Requested appointment location (choose all that apply)*
- Select All
- Wilmington (Foulk Road)
- Newark (Omega Drive)
- Telehealth (Remote)
Note: Initial TMS consult is offered in both Wilmington and Newark but actual treatment is offered in Newark office only.
Name of insurance company*
What are your concerns?*
Comments
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Wilmington Office

Lombardy Medical Center
410 Foulk Road, Suite 102,
Wilmington, DE 19803

(302)478-6199 phone
(302) 384-7162 fax
frontdesk@serenemindsllc.com

Newark Office

Omega Professional Center
80 Omega Dr, Bldg C
Newark, DE 19713

(302) 266-4403 phone
(302) 384-7162 fax
frontdesk@serenemindsllc.com

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