Please read the following information very closely and in entirety...

For all initial evaluations, please do the following: 
  1. Please print and fill out (in entirety) the appropriate initial evaluation packet, and bring it to the appointment.  Please provide an answer for every question.  It is extremely important that these forms be completed prior to the evaluation.  Not doing so will delay the start time and may  result in forfeiture of the appointment, at full cost to you. **Do not wait until the last minute to complete this paperwork!**
  2. ​Please bring a government-issued form of photo identification with you.
  3. Please bring the bottles of any and all medication you are currently taking on a regular basis, even if prescribed by your primary care physician.  **This includes herbal supplements and "over-the-counter" medication. 
  4. When applicable, please bring copies of any child custody agreement / legal guardianship paperwork with you to the appointment. 
  5. Please bring copies of any additional historical information you may have (previous doctor's notes, therapist's notes, lab results from blood work, etc).
  6. ​Please remember to bring your method of payment (cash, check, credit/debit card, health savings/flexible spending card).   We look forward to meeting you!​
Office Location:
The Fort Christian Psychiatric Center
110 North Park Drive
Fayetteville, GA 30214
Phone: (770) 376-6726
Fax: (770) 376-6727
Office Hours:
Monday: 7am - 7pm
Tuesday: 7am - 7pm
Wednesday: 7am - 7pm
Thursday: 7am - 7pm
Fri, Sat, Sun: CLOSED
​**All sessions are by appointment only
DISCLAIMER:  Completing intake forms does not guarantee an appointment.  A doctor-patient relationship is not established until the decision to create one is made at the conclusion of the initial psychiatric diagnostic evaluation.  Therefore, a person does not become a patient of Shaw Wendi Fortuchang, M.D., PC / The Fort Christian Psychiatric Center (or its associates) until decided so by Dr. Fortuchang.  
​Prescriptions are only given once a person becomes a patient. 

**We check the prescription history of every potential (and existing) patient via The Prescription Drug Monitoring Program.  This safety measure is mandated by the Georgia Psychiatric Physicians Association, The American Psychiatric Association and The American Medical Association.  
​
IMPORTANT: *If it is determined that you are not a fit for our practice, or that a more acute level of care is required (ie: crisis stabilization via hospitalization, partial hospitalization or intensive outpatient services), and our outpatient services are insufficient for your needs, we will notify you immediately.  
​We are not an acute care facility and we do not provide such services.*

INITIAL EVALUATIONS

HIPAA Notice/Patient Notice of Privacy Policies
​​​​TFCPC Credit Card Form
New Adult Packet - ​FEMALE
New Adult Packet - MALE
New Child/Adolescent Packet - ​FEMALE
New Child/Adolescent Packet - MALE
​Adolescent Questionnaire
​Pearls of Wisdom - ADULT
Pearls of Wisdom - CHILD & ADOLESCENT
Office Policies, Protocol and Procedure
​Vanderbilt Assessment Scale- Parent
​​​Vanderbilt Assessment Scale- Teacher 
Vanderbilt Assessment Scale- Parent Follow-Up 
Vanderbilt Assessment Scale- Teacher Follow-Up 
​​Spirituality Questionnaire

ESTABLISHED PATIENTS

Anxiety Tools
Release of Information Form
Fervent Prayer
Mood Tracker
Relaxation Techniques
Therapeutic Bath Soak Recipe
Sleep Diary
CY-BOCS- Parent Report
​Crisis Survival Skills
​​​Forgiveness Prayer
​​​​​​​Challenging Negative Thoughts Worksheet
​​​Confessing and Believing God's Promises for Your Life!
​​Becoming FORTIFIED in The Lord
Insurance Reimbursement Form & Information
ERP Homework Sheet

REFERRALS & CONSULTATIONS

Adult Psychiatry Referral Form
​​​​​​Child & Adolescent Psychiatry Referral Form
​​​​Forensic Psychiatry Referral Form​​​
"If you can't fly, run; if you can't run, walk; if you can't walk, crawl; but by all means keep moving."  
                                                                                             Reverend Dr. Martin Luther King, Jr. ​