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Up Ahead Psychiatry

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Reason for care

Select date & time

1 Appointment info

2 Prescreener

Reason for care

3 Contact information

What is the reason for seeking care?

Anxiety Attentional difficulties Behavioral issues Depression Grief Relationship issues Substance use Trauma Mood issues Sleep

What are you hoping for?

Medication evaluation ADHD evlaulation Mood support Anxiety support Second opinion Changing provider Other

What mental health concerns or treatment have occurred in the past?

In therapy now In therapy in the past Taking psychiatric medication now Taken psychiatric medication in the past Hospitalized for mental health reasons now or recently Hospitalized for mental health reasons in the past Known neurologic or genetic disorder Attempted suicide in the past None of these apply

Have you previously been prescribed: (Select all that apply)

Please note, I do not prescribe long-term benzodiazepines or opioid medications. My practice focuses on evidence-based medication management for mood, anxiety, ADHD, and related conditions.

Benzodiazepines (Xanax, Ativan, Klonopin, etc.) Opioids Antidepressants Antipsychotics None of the above

For medical emergencies, contact your healthcare provider or call 911. For mental health crises, call or text 988.

Up Ahead Psychiatry

716.451.3616 |

Buffalo

Main Location

Buffalo, NY 14202-1122

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THE CLIENT PORTAL IS NOT TO BE USED FOR EMERGENCY SITUATIONS. IF YOU OR OTHERS ARE IN IMMEDIATE DANGER OR EXPERIENCING A MEDICAL EMERGENCY, CALL 911 IMMEDIATELY.