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Primary Care

Specialties & Services

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Primary Care

Specialties & Services

We are currently experiencing issues with our fax lines; we are only intermittently receiving faxes for records and prescriptions at the moment. We are working to resolve the issue as quickly as possible.

Behavioral Health

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Click on a form below to e-sign it or print and fill it out!

E-signed forms require no additional interaction once submitted. If you choose to provide your email address during this process, you will receive a notification shortly afterward that the form has been deleted. That is confirmation that your form has been moved into your patient chart and removed from the e-sign system. 

 

Print-and-fill-out forms can be used for your own reference! If requested, print-and-fill-out forms may be returned to InterMed via Secure File Upload, mail, or fax to our Medical Records Department at (207) 523-8581.

 

Crisis Resources

  1. Hotline triangle
  2. Safety plan template

ADHD

  1. ADHD fact sheets (CHADD)

Anger

  1.  Slow down and THINK
  2.  Anger iceberg
  3.  Assertive communication
  4.  Chart of feelings

Anxiety/Depression

  1.  Break the anxiety cycle with CBT
  2.  How do deal with negative thoughts?
  3.  Challenging negative thoughts
  4.  Socratic questioning
  5.  Grounding techniques
  6. Things I worry about
  7.  Chart of feelings
  8. Behavioral activation for depression
  9. Strategies for skin-picking

Assessments/Questionnaires

  1. Affective Reactivity Index parent report
  2. Affective Reactivity Index teen report
  3. ASRS-O
  4. Consensus Sleep Diary
  5. General anxiety disorder Scale (GAD-7)
  6. MFQ child self-report short
  7. MFQ parent report on child short
  8. Patient Health Questionnaire (PHQ-9)
  9. Patient Health Questionnaire (PHQ-9) – Teens
  10. Preschool PSC
  11. PSC Pediatric Symptom Checklist
  12. SCARED Child
  13. SCARED Parent
  14. Springboard Adult ADHD Self-Report Scale Symptom Checklist
  15. Weiss Functional Impairment Rating Scale (Self-Report)
  16. Wender Utah Rating Scale for the Attention Deficit Hyperactivity Disorder
  17. Vanderbilt ADHD Assessment – Initial Parent Form
  18. Vanderbilt ADHD Assessment – Initial Teacher Form

  19. Vanderbilt ADHD Assessment – Follow-up Parent Form (E-Sign)

  20. Vanderbilt ADHD Assessment – Follow-up Teacher Form
  21. Yale-Brown Obsessive Compulsive scale and symptom checklist

  22. Edinburgh Postnatal Depression Scale Screening

 

Eating Disorders

  1. F.E.A.S.T. Support and Education Community
  2. Caregivers Do’s and Don’ts
  3. Monte Nido & Affiliates | Parent/Caregiver Support Group, Tuesdays 6-7pm EST
  4. FREE Online Group for Family and Friends
  5. NEDA Parent Toolkit

 

Forms/Policies

  1. Controlled Medication Agreement (for ages 13+)
  2. Stimulant agreement
  3. Psychiatric disability and work leave

Mindfulness

  1.  Art of being present
  2. Twelve essential rules to live more like a Zen monk
  3.  Mind full or mindful?

Sleep

  1. Consensus Sleep Diary
  2.  Free Cognitive Behavioral Therapy for insomnia, CBTi
  3. Sleep hygiene
  4. Improving sleep

Stress Management

  1.  Self care
  2.  Stress management during COVID-19
  3.  Mental health wellness during a quarantine
  4. Seven tips for how to cope when things feel out of control

Other Resources

  1. Counseling resources
  2. Katie Beckett application process guide