Patient Forms

Prior Treatment History

Prior Treatment History Form

Patient Registration Forms

The packet includes: Registration Information, Consent for Treatment, Office Policies & Procedures, Patient Report, and the Symptom Checklist.

Outgoing Patient Records Form

Consent to release our patient’s information to outside organizations.

Incoming Patient Records Form

Consent to release patient information from outside organizations to our office.

Credit Card Authorization Form

This form will be under lock and key along with your medical records.

Freespira Program Registration Paperwork

Explanation of the program and policies

Assignment of Benefits Agreement

Our policies governing insurance claims.

HIPAA Notice of Privacy Practices

HIPPA Notice of Privacy Practices

Office Policies

Just a summary of our office policies.

Contact Us

about our services and we will get back to you about what we can do for you.


Silicon Valley TMS of San Jose

2039 Forest Ave
Suite 201
San Jose, CA 95128

Phone: 408-358-8090

Office Hours:
Mon-Fri: 9am-5pm

Silicon Valley TMS of East Bay

5776 Stoneridge Mall Rd
Suite 376
Pleasanton, CA 94588

Phone: 925-272-4100

Silicon Valley TMS of San Francisco

595 Buckingham Way
Suite 505
San Francisco, CA 94132

Phone: 415-294-4090

Silicon Valley TMS of Monterey Bay

2425 Porter Street
Suite 11
Soquel, CA 95073

Phone: 831-296-5700

Silicon Valley TMS of Mountain View

525 South Drive
Suite 211
Mountain View, CA 94040

Phone: 650-900-8181