Child Psychiatry
Preparing for your first visit
ROI Form: Release of Information. To authorize the release of health information.
SNAP Form: The Swanson, Nolan, and Pelham Rating Scale (SNAP-IV).
Teacher Feedback Form: For teachers to fill out.
Forms
Patients should complete the Guide to Clinical Services, Life History Questionnaire, Teacher Feedback Form, and SNAP form prior to their appointment.
For your convenience, forms will be sent via secure link from our administration team to be filled out and returned digitally.
Below are download links to the most commonly requested PDF forms
Helping your child understand what will occur at my office: Tell your child that the practitioner would like to find out how they learn, think, and feel so we can work together with the family to find solutions to problems at school, home, or with friends.
For younger children, two appointments might be necessary, one for the child and one for the adult, unless a companion can attend the appointment to help mind the child while the parents talk to the practitioner.
Please arrive 15 minutes early for your appointment.
Helping your child understand what will occur at the office:
Policies
Payment
Hampton Insights does not accept insurance. Dr. DeFrancisci Lis will give patients a copy of invoices to submit to insurance or health care spending accounts. Patients are responsible for submitting these bills and Hampton Insights will not be held accountable if insurance does not reimburse the full amount or pay in a timely manner.
Appointment Cancelations
Any appointment cancelled with less than 24 hours notice will be billed at $200. Fees are due at the time of service - payments acceptable are cash, personal check, benefit, and debit cards. MasterCard, Discover, and American Express are accepted but will incur a 3% service charge.