Nick Jafary, MD
BECKLEY PSYCHIATRIC SERVICES
Call Us: 304-929-0786
New Patient Form
What do you want to see the doctor for?
What is your current diagnosis?
Have you seen a psychiatrist before?
Are you currently taking any medications?
Have you ever taken any narcotic medications?
Have you been in a suboxone program or any narcotics abuse program before?
Who is your insurance carrier?
If no insurance is available there is a $150.00 first visit fee and $85.00 for follow-ups
How did you hear about our clinic?