• CRAFFT (Car, Relax, Alone, Forget, Friends, Trouble)
  • HCL-32 (Hypomania Check List Questionnaire) INCOMPLETE
  • MDQ (Mood Disorder Questionnaire)
  • Intake Questionaaire for New Patients (adults)
Laverdure Psychiatry: Electronic Intake Packet (Adolescents)

Note: Call 24 hrs. advance to avoid a show/no call fee. Please arrive 30 minutes early to check-in, visit with the nurse, or take care of any extra information that is needed for your appointment. 

Intake: $100             Follow-Up: $25

Directions: please complete the intake packet to the best of your ability. If you have any questions please contact our office at (406)-945-9019

*mandatory fields