Spiritually in this case refers to your "spirit," what makes you who you are and unique from everyone else. Infusing that part of you into your psychiatric care sets you up for success. Whatever guides you through life should be a part of what guides us through your treatment and deciding what is right for you. You don't have to be a spiritual or religious person in any way and my goal is not to make you into a spiritual or religious person. I honor all paths, without judgment. 

A psychiatric mental health nurse practitioner (PMHNP) is a master's degree-prepared nurse that has extensive education on mental health disorders, diagnosis, and treatment. PMHNPs perform psychiatric evaluations and provide medication management and psychotherapy. Colorado is a full practice act state, allowing PMHNPs to work independently and are able to prescribe medications. Board certification is required to practice and is achieved by passing a comprehensive exam through the American Nurses Credentialing Center.

I do not routinely sign off on these forms. It may be evaluated on a case-by-case basis, but typically will not.

After the psychiatric evaluation, we will determine the best approach for you. Benzodiazepines are indicated in some instances, but they are not intended for long-term use, and rarely are they first-line treatment. There are many options for the management of most disorders and I respectfully ask that you understand my practice is to limit the use of benzodiazepines. 

After the psychiatric evaluation, we will determine the best approach for you to treat the symptoms you are experiencing. If you have a history of cardiac conditions you may be required to obtain an EKG and clearance letter from your primary care doctor or cardiologist. Additional screenings and information may be obtained prior to deciding if a stimulant is right for you. 

Hypnotics are not meant for long-term use and are not a first-line treatment for insomnia. Prior to prescribing a hypnotic, I do require good sleep hygiene practices and possibly therapy to address sleep issues. There are several ways to approach and treat insomnia and I will work with you to determine the best options for you.

If you have lost your medication, you should file a police report and inform us, as well as the pharmacy, that you have lost your medication. Controlled medications will not be filled earlier than their fill date. To prevent loss of your medications, you should keep them in a secured location, out of reach of children, and should never travel with more medication than you need for your trip duration. 

The time scheduled for your appointment is assigned to you and you alone. I require a full 24 hours notice for all cancellations except in cases of emergencies. If 24 hours notice is not received, you will be billed the fee for that missed appointment, which will need to be paid prior to rescheduling your appointment. I understand that situations out of our control arise, but excessive (2 or more) episodes of late cancellations or missed appointments may lead to termination of care. If you are more than 15 minutes late to an appointment, your appointment may need to be rescheduled. It is important you arrive on time and consistently attend your appointments to help maximize your mental health outcomes. 

I do require the first appointment to be in person unless there is an extenuating circumstance that prevents you from coming in. Once you have been seen in person we can discuss the appropriateness of online versus in-person appointments. I am always happy to see you in person.

Your information is not disclosed to anyone without your consent unless required to do so by law or as needed for billing purposes. For patients 15 years and older, the patient needs to sign a release of information in order for us to disclose information to legal guardians.