Please download each document from the list below. Follow the directions located at the top of each questionnaire, answer all questions, and save the completed forms on your personal computer. After you have completed all required forms, you may either email or mail them to our Patient Care Coordinator for processing.

When emailing, please email to If using regular mail, please send all documents to:

Kolp Institute

Attn: Applications

5618 Northwest 43rd Street

Gainesville, FL 32653

All questionnaires are completely confidential and will remain a part of your medical record.  Information on requesting your medical records may be found on our Frequently Asked Questions page. Please Note: The Informed Consent must be printed, signed, and the original must be returned to our office before we can schedule your psychiatric evaluation.

Please Complete the Following: