Please read below carefully,
as our Forms submission options have changed.

Links to all forms are provided below, in the Patient Forms section.
Please select & download these forms to fill them out.

When completed, please choose from one (1) of the following three (3) methods, to deliver your forms to us.

I.   Email your completed form to - [email protected]

[email protected]

II.  Bring by or postage mail to our office location @ :

Upstate Psychiatry, P.A.
27 Memorial Medical Dr
Greenville, SC 29605

Patient Forms

Please Notice:
Both the Tele-Consent Form and Rights & Responsibilities Forms
MUST be completed for any/all new patients.

Release of Information

Child Forms

Adult Forms

Insurance Forms

Tele-Consent Form

Rights & Responsibilites Form

Physician Referral Form

  • Patient Forms

  • Physician Forms

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