Zabrin Inan,ADD/ADHD,mood disorders,depression,eating disorders,anxiety

Dr. Zabrin Inan, MD
Child, Adolescent and Adult Psychiatry
Chicago

HOMECONTACT DR. INAN
NEW PATIENT INFO
FAQ about Mental Health

LEARN MORE ABOUT...
ADD/ADHDAnxiety DisordersBipolar DisorderDepression/ Mood DisordersEating DisordersSexual Orientation

MORE INFO
Online ResourcesSITE MAP

Patient Forms & Self Tests

NEW PATIENTS:
Thefive forms below are interactive forms, which means you can download
them to your computer, save them and fill them out electronically and
then bring them to your appointment with Dr. Inan.

You also can fax or email them directly (and securely) to Dr. Inan:

773.303.8242 Fax    -    drinan@zabrininanmd.com

PATIENT INFORMATION FORM
DOWNLOAD THIS FORM

ADULT MEDICAL/FAMILY HISTORY
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CHILD/ADOLESCENT MEDICAL/FAMILY HISTORY
DOWNLOAD THIS FORM
Must be filled out by a child/adolescent's
parent or legal guardian

CONSENT FOR RELEASE OF INFORMATION
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CO-PAY INFORMATION FORM
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OTHER FORMS (.pdf, not interactive)
PATIENT INFORMATION AND INFORMED CONSENT
This document spells out our payment policy.
You must read this document and indicate your understanding and consent with a signature.
DOWNLOAD THIS FORM

CONSENT FOR TREATMENT
DOWNLOAD THIS FORM

INTERACTIVE SELF TESTS
Patients can fill out these forms electronically,
print out the tests and
bring themfor further consultation

 

ADD/ADHD

 

Stress Scales for Adults and Youth

 

Online Screening for Anxiety

 

Bipolar Screening Test

 

Child's Compulsions Checklist

 

Child's Obsessions Checklist

 

Online Depression Screening Test

 

Eating Attitudes Test

 

Generalized Anxiety Disorder Self Test

 

Panic Disorder Self Test


INFORMATION SHEET

Common Tics of Tourette Syndrome

STIMULANT PRESCRIPTION INFORMATION


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Dr. Zabrin Inan, MD
Chicago
office@zabrininanmd.com
Copyright 2003-2007 All rights reserved.