Geoffrey Di Bella, MD    Psychiatrist DBA: OPTILIFE, Inc.

Please print the following forms... see links below:

Patient Intake Packet... all first time patients.

Also you need to fill out the  questions at                  https://v9.clinicomapi.com/home/register/261/0/en/0/0/0/0

And: for those under 18,  then also the

Minor Intake forms



Getting these submitted needs to be done by 1 day before the consultation time.  

 If you have not been at the office in over 18 months, you need to fill in new Intake Forms/First Visit.