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Todd S. Cox, MD, DFAPA

BOARD CERTIFIED PSYCHIATRIST


Helpful Forms

 

 

Information about the office location and policies:


If you are a new patient, please complete the following forms and bring them to your first session or fax (202-223-8531) or e-mail (toddscoxmd@aol.com) them prior to the appointment:

 
Complete this form to authorize communication with other clinicians and/or other individuals with whom you wish your medical information to be shared:

 
For current patients, please be sure that we have the most accurate information contained on the following forms:

 
For patients who have Medicare Part B, please complete the Medicare Opt Out Agreement:



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