Step 3 of 3: Fill Form 3
Consent to Treatment
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Stellar Psychiatry
Welcome to Stellar Psychiatry. This document is intended to inform you about your rights, responsibilities, and the nature of treatment services provided. Please read this document carefully and submit your consent below.
Purpose of Treatment
The purpose of psychiatric and mental health treatment is to assess, diagnose, and provide appropriate care for emotional, behavioral, and mental health conditions.
- Psychiatric evaluations
- Medication management
- Psychotherapy/supportive counseling
- Treatment planning and follow-up care
Patient Rights
- Be treated with dignity and respect
- Participate actively in treatment decisions
- Ask questions regarding your care
- Refuse treatment to the extent permitted by law
- Receive confidentiality and privacy protections
Confidentiality
Your health information will remain confidential except where permitted or required by law.
Telehealth Services
- You understand technology failures may occur.
- You consent to electronic communication platforms.
- You acknowledge privacy risks with unsecured devices.
Medications
- You understand medication risks and benefits.
- You agree to take medications only as prescribed.
Financial Responsibility
- Providing accurate insurance information.
- Payment of applicable fees.
- Responsibility for missed appointments if applicable.
Emergency Situations
Stellar Psychiatry does not provide emergency crisis services. If experiencing an emergency call 911 or go to the nearest emergency room.
Consent
- You have read and understood this Consent to Treatment form.
- You had the opportunity to ask questions.
- You voluntarily consent to treatment services.




