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Kenneth R. Cohen, M.D.
Psychiatry Practice in New York City and Sharon, Connecticut  psychotherapy • psychoanalysis • psycho-oncology consultation-liaison psychiatry • psychiatric home visits |
tel: 212-580-3433 | fax: 844-471-4762 | mail@kennethrcohenmd.com
Patient Information and Treatment Agreement (Click to Print)
Please print, complete, sign, date, and return this form prior to your initial consultation. You may fax the completed form to the appropriate office location or scan/email it to mail@kennethrcohenmd.com
Consent for Release or Exchange of Confidential Information (Click to Print)
If you have been in treatment with a psychiatrist or therapist in the past, feel free to complete this consent and bring it with you to your initial consultation. Completing a consent form is recommended but not compulsory, and can be done at any time.
Private Contract for Patients Insured by Medicare (Click to Print)
All patients insured by Medicare must complete and sign this contract before or during the initial consultation.
Tel: 860-364-5065 | Fax: 844-471-4762 | mail@kennethrcohenmd.com