Schedule An Appointment With Dr. Jeffrey Simon, MD Psychiatrist

To schedule an appointment or to obtain additional information about any of our medical services, please fill out the form below or give us a call.

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If you are a new patient, please fill out the following forms* and bring them with you to your first appointment.

• Consent to Release Receive Confidential Info
• Initial History Questionnaire
• Patient's Consent to Treatment Form
• Personal Information Form
• Pharmacy Consent Form
• Patient Treatment Contract (for patients interested in Suboxone Maintenance/Vivitrol Therapy)

* Forms are in PDF format. To download a free copy of Adobe Acrobat, click here.

Dr. Simon provides all of his patients with an additional phone number where private messages can be left, directly for the doctor 24 hours a day.  Messages are checked regularly and return calls are placed within one business day.  If the situation can be managed in an outpatient setting, you will be seen in the office in a timely manner.  In case of an emergency which cannot wait, please immediately call 9-1-1 or go to the nearest emergency room.