DISCLAIMER:  Completing our 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 provided once a person becomes a patient. 

**We routinely check the prescription history of every potential (and existing) patient via The Prescription Drug Monitoring Program.  This extremely important safety measure is mandated by The Georgia Composite Medical Board, The Georgia Department of Public Health, 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 virtual 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 EVALUATION FORMS

​Credit Card Authorization Form
HIPAA Notice/Patient Notice of Privacy Policies​
Adult Packet - ​​​​​​​​​​​FEMALE
 Adult Packet - ​MALE
Child/Adolescent Packet - ​​​​​​​FEMALE
Child/Adolescent Packet - MALE
​Adolescent Questionnaire
​Office Policies, Protocol & Procedure
​Pearls of Wisdom - ADULT
Pearls of Wisdom - CHILD & ADOLESCENT
Procedure Codes for Billing Insurance 
Procedure Code Algorithm for Billing Insurance
Release of Information Form ADULT
Release of Information Form CHILD/ADOLESCENT
Tele-Psychiatry Consent Forms for New Evaluations​
TFCPC Procedure Codes  
​Vanderbilt Assessment Scale- Parent
​​​Vanderbilt Assessment Scale- Teacher 
Vanderbilt Assessment Scale- Parent Follow-Up 
Vanderbilt Assessment Scale- Teacher Follow-Up 
​​​Spirituality Questionnaire

ESTABLISHED PATIENT FORMS

Becoming FORTIFIED in The Lord
Benefits of Change Worksheet​
Christian Mindfulness Meditation
​​​Confessing and Believing God's Promises for Your Life!
Credit Card Authorization Form
CY-BOCS- Parent Report
​Daily Mood Tracker
​​​​​​​Dealing with Negative Thoughts Worksheet
ERP Homework Sheet
Fervent Prayer
​​​Forgiveness Prayer
General Consent Form- ADULT
General Consent Form- CHILD/ADOLESCENT
Insurance Reimbursement Form & Information
Office Policies, Protocol and Procedure
Release of Information Form ADULT
Release of Information Form CHILD/ADOLESCENT
Tele-Psychiatry Consent Forms for Established Patients
Therapeutic Bath Soak Recipe
"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. ​