NEW PATIENT CALENDAR GATEWAY

1
Are you currently in a state of crisis involving active thoughts of suicide or homicide?* This field is required.
YESNO
2
It seems you answered "yes" to the last question. We do not know your identity linked to this answer but we do know that this state of CRISIS this is not something to take lightly.

Generally , outpatient scheduling is not a safe option if you are at imminent risk of harm to self or others.

Please do contact Emergency psychiatric resources listed in the following link or call 911. Again. Please see the following links for more emergent care:

EMERGENCY RESOURCES PAGE

THE TOOL DOES NOT COLLECT ANY PERSONALLY IDENTIFIABLE INFORMATION .AND "SUBMIT" BUTTON ROUTES TO AN AUTO DELETE TRASH BIN. (THUS THE SUBMIT BUTTON IS ESSENTIALLY MEANINGLESS IN THIS TOOL AS SUBMITTING OR NOT SUBMITTING THE FORM WILL NOT RESULT IN ANY SUBSTANTIVE INFORMATION TRANSIMISSION EITHER WAY) THIS STEP IS PRIVATE ANONYMOUS AND ONLY TO HELP YOU ON YOUR JOURNEY.
3
Does a significant part of your current difficulties involve drug or alcohol over-use?* This field is required.
YESNO
4
Drug and Alcohol over-use (as with addiction and chronic abuse) deserve the same serious treatment approach as any illness. That said, they must be tackled first before other symptoms ( such as depressions anxieties sleep disorders) are able to be successfully assessed and treated program can take place. This is because drug and Alcohol addition and chronic abuse can distort, overlap and or mask underlying symptoms - making accurate underlying diagnosis essentially impossible until these are treated. Unfortunately Dr DePalma is not an addiction medicine Psychiatrist and does not practice as such. Thus if your use of alcohol or drugs currently is a significant addiction or abuse issue on its own, it should be best first dealt with by an addiction specialist or treatment program before embarking on a regimen of treatment for non-substance related psychiatric symptoms. For treatment resources please see links here:

ADDICTION RESOURCES PAGE

THE TOOL DOES NOT COLLECT ANY PERSONALLY IDENTIFIABLE INFORMATION .AND "SUBMIT" BUTTON ROUTES TO AN AUTO DELETE TRASH BIN. (THUS THE SUBMIT BUTTON IS ESSENTIALLY MEANINGLESS IN THIS TOOL AS SUBMITTING OR NOT SUBMITTING THE FORM WILL NOT RESULT IN ANY SUBSTANTIVE INFORMATION TRANSIMISSION EITHER WAY) THIS STEP IS PRIVATE, ANONYMOUS AND ONLY TO HELP YOU ON YOUR JOURNEY.
5
Dr DePalma performs IN PERSON and ONLINE appointments. Some local patients prefer all IN PERSON appointments while others and those who live further prefer a MIX of IN PERSON and ONLINE* This field is required.
OK, Got it
6
I understand that though I may be seeking ONLINE appointments, I will need to drive to meet with Dr DePalma in person for the first appointment even if I live hours away.* This field is required.
That sounds reasonable to me! I can do that!
I would not be able to travel to meet with Dr DePalma in person for the first visit or after that even once a year.
7
The difficulty traveling such as driving from other parts of Arizona several hours is understandable and unfortunatley not everyone may have the ability to do so.

However because of state regulations around prescribing and online treatment, as well as for reasons of patient safety and providing quality care, Dr DePalma will not be able to take you on as a patient .

If you are looking for a local provider who accepts AHCCCS/medicaid you may want to start here :

https://www.azahcccs.gov/Members/BehavioralHealthServices/

Otherwise, we suggest looking through the Psychology Today Website as a resource to find a local mental health prescriber if you are looking for a private practice provider. https://www.psychologytoday.com/us/psychiatrists/az/phoenix

We wish you the best of luck in your search for a provider in your area.

THE TOOL DOES NOT COLLECT ANY PERSONALLY IDENTIFIABLE INFORMATION .AND "SUBMIT" BUTTON ROUTES TO AN AUTO DELETE TRASH BIN. (THUS THE SUBMIT BUTTON IS ESSENTIALLY MEANINGLESS IN THIS TOOL AS SUBMITTING OR NOT SUBMITTING THE FORM WILL NOT RESULT IN ANY SUBSTANTIVE INFORMATION TRANSIMISSION EITHER WAY) THIS STEP IS PRIVATE, ANONYMOUS AND ONLY TO HELP YOU ON YOUR JOURNEY.
8
I also understand that, after this, if I live far, though the majority of my appointments may be ONLINE , I will need to drive to see him IN PERSON once a year at a minimum and possibly more than that if the Dr feels that IN PERSON is needed for some reason such as monitoring the affect a medication may have on my blood pressure. (Patients are also welcome to request that all or most appointments be IN PERSON if preferred)* This field is required.
That sounds reasonable to me! I can do that!
I would not be able to travel to meet with Dr DePalma in person for more times than just the first visit.
9
The difficulty traveling such as driving from other parts of Arizona several hours is understandable and unfortunatley not everyone may have the ability to do so.

However because of state regulations around prescribing and online treatment, as well as for reasons of patient safety and providing quality care, Dr DePalma will not be able to take you on as a patient .

If you are looking for a local provider who accepts AHCCCS/medicaid you may want to start here :

https://www.azahcccs.gov/Members/BehavioralHealthServices/

Otherwise, we suggest looking through the Psychology Today Website as a resource to find a local mental health prescriber if you are looking for a private practice provider. https://www.psychologytoday.com/us/psychiatrists/az/phoenix

We wish you the best of luck in your search for a provider in your area.

THE TOOL DOES NOT COLLECT ANY PERSONALLY IDENTIFIABLE INFORMATION .AND "SUBMIT" BUTTON ROUTES TO AN AUTO DELETE TRASH BIN. (THUS THE SUBMIT BUTTON IS ESSENTIALLY MEANINGLESS IN THIS TOOL AS SUBMITTING OR NOT SUBMITTING THE FORM WILL NOT RESULT IN ANY SUBSTANTIVE INFORMATION TRANSIMISSION EITHER WAY) THIS STEP IS PRIVATE, ANONYMOUS AND ONLY TO HELP YOU ON YOUR JOURNEY.
10
Are you wishing to have a specific medication or medications filled including any that you are taking now or have taken in the past?* This field is required.
YES and I have a preference for a specific medication or medications
NO, I have no particular preference for what medication may or may not be filled
11
As a Psychiatrist, Dr DePalma prescribes many classes of medications including NON-CONTROLLED medications such as the anti-depressants and mood stabIlizers as well as the CONTROLLED medications such as stimulants (like Adderall) and sedatives (like xanax and Ambien). If you are now or have been prescribed medications in the past, some of the medications you want to be filled may be NON-CONTROLLED and some of them may be CONTROLLED, such as ADHD meds (like Adderall) and sedatives (like xanax and Ambien)* This field is required.
Got It
12
Controlled medications like Adderall and Ritalin (stimulant medications) and Xanax Valium and Klonopin (sedative medications) are classified based based on : The potential for Abuse of the Drug, The potential for Addiction to the Drug and whether or not the drug has an accepted medical use.* This field is required.
Got It
13
Though these drugs ( in controlled classes) can be problematic for some individuals if they are abused, when taken in appropriate dosages and in a regular scheduled manner the chance of any significant addiction is very low. As opposed to when they are taken in high dosages, or taken haphazardly* This field is required.
Got it
14
Another issue is that the addiction potential can compound if two scheduled medications are taken together or if scheduled medications like a stimulant or xanax are taken with substances like alcohol or marijuana. This can result in the person becoming more addicted to BOTH medications/substances - due to the combined addictive effects.* This field is required.
Got it
15
Dr DePalma understands that medications from the controlled classes are absolutely useful and necessary in many cases and certainly does prescribe these medications, however, we also believe that it is in the best interest of prospective patients to inform them of some of Dr DePalmas typical prescribing limitations beforehand... such as :
16
Though Dr DePalma often prescribes more than one medication at a time, Dr DePalma does not typically prescribe more than one controlled medication to one patient at any one time.*due to the previously mentioned possible increase in addictiveness when they are combined. (so if you are hoping to be prescribed more than one controlled medication , you most likely will not be prescribed more than one at the same time by Dr DePalma.)* This field is required.
Sounds like a safe policy. I am fine with that.
I don't like this policy.
17
We understand and it sounds like you may be better served seeking a different provider.

Dr DePalma is quite consistent on out of concern for patient safety and his desire not to worsen the mental health of any patient / create or contribute to dependency.

Because it sounds like your desires and our Practice Policies don't line up its likely you may not be happy with our treatments. One of our priorities is to not waste the time or money of any prospective patient or patient so you may wish to seek services from a different community provider.

THE TOOL DOES NOT COLLECT ANY PERSONALLY IDENTIFIABLE INFORMATION .AND "SUBMIT" BUTTON ROUTES TO AN AUTO DELETE TRASH BIN. (THUS THE SUBMIT BUTTON IS ESSENTIALLY MEANINGLESS IN THIS TOOL AS SUBMITTING OR NOT SUBMITTING THE FORM WILL NOT RESULT IN ANY SUBSTANTIVE INFORMATION TRANSIMISSION EITHER WAY) THIS STEP IS PRIVATE, ANONYMOUS AND ONLY TO HELP YOU ON YOUR JOURNEY.
18
Patients with medical contraindications may not be eligible for certain types of medications such as stimulants if patient has HTN or benzodiazepines if patient has a history of substance abuse.* This field is required.
Sounds like a safe policy. I am fine with that.
I don't like this policy
19
We understand and it sounds like you may be better served seeking a different provider.

Dr DePalma is quite consistent on out of concern for patient safety and his desire not to worsen the mental health of any patient / create or contribute to dependency.

Because it sounds like your desires and our Practice Policies don't line up its likely you may not be happy with our treatments. One of our priorities is to not waste the time or money of any prospective patient or patient so you may wish to seek services from a different community provider.

THE TOOL DOES NOT COLLECT ANY PERSONALLY IDENTIFIABLE INFORMATION .AND "SUBMIT" BUTTON ROUTES TO AN AUTO DELETE TRASH BIN. (THUS THE SUBMIT BUTTON IS ESSENTIALLY MEANINGLESS IN THIS TOOL AS SUBMITTING OR NOT SUBMITTING THE FORM WILL NOT RESULT IN ANY SUBSTANTIVE INFORMATION TRANSIMISSION EITHER WAY) THIS STEP IS PRIVATE, ANONYMOUS AND ONLY TO HELP YOU ON YOUR JOURNEY.
20
If you are a heavy (regular use marijuana smoker/consumer) and you feel that you rely heavily on marijuana and will NOT be able to stop your regular use of marijuana in order to be treated with medication, you are most likely NOT a good fit for treatment with Dr DePalma.* This field is required.
I do NOT regularly use marijuana and this is not a problem for me at all
I do rely on marijuana significantly as I find it helps me in many ways and don't think I will be able to terminate use in order for successful medication treatment
21
We understand and it sounds like you may be better served seeking a different provider.

Dr DePalma is quite consistent around policies regarding marijuana use and psychotropic treatment out of concern for patient safety and has seen (MANY) patients end up in a serious Psychosis requiring Hospitalizations due to combined use of marijuana and psychotropics.

Thus, it is best you not pursue treatment with this provider at this time. However if this changes in the future and you have been off of this substance for a period of at least months feel free to let us know and we will be here for you.

Because it sounds like your desires and our Practice Policies don't line up its likely you may not be happy with our treatments. One of our priorities is to not waste the time or money of any prospective patient or patient.

We wish you the best on your journey and in the case you do find that you are addicted to THC, here are some helpful resources:

RESOURCES PAGE

THE TOOL DOES NOT COLLECT ANY PERSONALLY IDENTIFIABLE INFORMATION .AND "SUBMIT" BUTTON ROUTES TO AN AUTO DELETE TRASH BIN. (THUS THE SUBMIT BUTTON IS ESSENTIALLY MEANINGLESS IN THIS TOOL AS SUBMITTING OR NOT SUBMITTING THE FORM WILL NOT RESULT IN ANY SUBSTANTIVE INFORMATION TRANSIMISSION EITHER WAY) THIS STEP IS PRIVATE, ANONYMOUS AND ONLY TO HELP YOU ON YOUR JOURNEY.
22
I do understand that Dr. DePalma is an “Out of Network Provider”. Meaning that he has opted out of Direct Insurance Contracts but that I do have the option to self submit my "superbills" (which Dr DePalma is more than happy to supply you with on request) to my insurance company for out of network reimbursement as allowed.
Yes, I understand
I'm not sure I understand and would like to read more about how this works first
23
* This field is required.IT SEEMS THAT DR. DEPALMA IS LIKELY A GOOD FIT FOR YOUR CURRENT MENTAL HEALTH PROVIDER NEEDS, AFTER USING THE CALENDAR ON THE NEXT PAGE TO REQUEST AN APPOINTMENT TIME YOU WILL BE AUTOMATICALLY EMAILED A LINK TO AN ENCRYPTED NEW PATIENT INFORMATION FORM . NOTE that appointment will not be officially approved however - until AFTER - THAT form is reviewed. IF (THAT) ENCRYPTED FORM SENT TO YOUR EMAIL IS NOT COMPLETED WITHIN 48 HOURS, UNFORTUNATELY WE WILL HAVE TO CANCEL YOUR REQUEST TO ENSURE EFFICIENT SCHEDULING FOR ALL PATIENTS
YES, I UNDERSTAND THIS AND WILL USE NEXT PAGE TO REQUEST AN APPOINTMENT
Other
24

CLICK HERE TO REQUEST

YOUR APPOINTMENT
25
Oh Hello There!

You just clicked the "Next" Button in lower Rt corner on the last page before clicking " confirm appointment" Didn't you? : )).

No worries, Mistakes happen . Just click "Previous" on the lower left corner of this slide to go back, then click on " confirm appointment" : )

See you at the appointment !
26
* This field is required.It is 100% understandable and reasonable for an individual to take some additional time to learn more about their insurance plans polices regarding whether they pay any out of network costs or not before moving forward with out of network treatment. The current fees due at time of service for Dr DePalma's sessions are as follows: 60 min Initial Diagnostic Evaluation $320 60 min follow up $310 30 min follow up $200 Some of our patients have part of this paid by insurance ( if they pay any out of network costs) and some of our patients pay it all themselves out of pocket. To find out if your insurance plan does pay any out of network costs :you can call your health insurance company BY DIALING THE NUMBER ON THE BACK OF YOUR INSURANCE CARD and ask the following: Does my plan include any "out of network coverage" for out of network Psychiatrists? If you have left this web page open while finding this information out feel free to go ahead and continue with making an Initial appointment request using the option below , otherwise , when you come back to the website just go through this "walk through” again as before to get back to the scheduling option.
Yes, I understand and would like to go forward requesting an initial Evaluation.
I would like to spend some more time learning if my insurance pays any out of network OR do not think this will work for me
27
* This field is required.IT SEEMS THAT DR. DEPALMA IS LIKELY A GOOD FIT FOR YOUR CURRENT MENTAL HEALTH PROVIDER NEEDS, AFTER USING THE CALENDAR ON THE NEXT PAGE TO REQUEST AN APPOINTMENT TIME YOU WILL BE AUTOMATICALLY EMAILED A LINK TO AN ENCRYPTED NEW PATIENT INFORMATION FORM . NOTE that appointment will not be officially approved however - until AFTER - THAT form is reviewed. IF (THAT) ENCRYPTED FORM SENT TO YOUR EMAIL IS NOT COMPLETED WITHIN 48 HOURS, UNFORTUNATELY WE WILL HAVE TO CANCEL YOUR REQUEST TO ENSURE EFFICIENT SCHEDULING FOR ALL PATIENTS
YES, I UNDERSTAND THIS AND WILL USE THE NEXT PAGE TO REQUEST AN APPOINTMENT
28
FINAL NOTE (WE PROMISE):

ON THE SECTION WHERE YOU ENTER YOUR NAME AND INFORMATION,

DO NOT CLICK THE "NEXT" BUTTON IN THE LOWER RIGHT CORNER BEFORE CLICKING

"CONFIRM APPOINTMENT"

OR THE REQUEST WILL NOT GO THROUGH!

Booking Provided by Healthie
29
Oh Hello There!

You just clicked the "Next" Button in lower Rt corner on the last page before clicking " confirm appointment" Didn't you? : )).

No worries, Mistakes happen . Just click "Previous" on the lower left corner of this slide to go back, then click on " confirm appointment" : )

See you at the appointment !
30
Please take as much time as you need. For additional resources you can also see the following web page : https://www.onepsychiatry.com/insurance-reimbursement.html

best,

Dr DePalma and One Psychiatry

THE TOOL DOES NOT COLLECT ANY PERSONALLY IDENTIFIABLE INFORMATION .AND "SUBMIT" BUTTON ROUTES TO AN AUTO DELETE TRASH BIN. (THUS THE SUBMIT BUTTON IS ESSENTIALLY MEANINGLESS IN THIS TOOL AS SUBMITTING OR NOT SUBMITTING THE FORM WILL NOT RESULT IN ANY SUBSTANTIVE INFORMATION TRANSIMISSION EITHER WAY) THIS STEP IS PRIVATE, ANONYMOUS AND ONLY TO HELP YOU ON YOUR JOURNEY.
Should be Empty: