Germantown Private Psychiatry PLLC

Dr Arif Mirza MD | Child, Adolescent, Adult Psychiatry & Psychopharmacology | Diplomate of American Board of Psychiatry & Neurology

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    • Expertise – Young Adults
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    • Arif K Mirza, MD
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Forms

New Patient Forms

We highly recommend to download and complete this at home before appointment OR Arrive 30 min early to finish it on time.

We look forward seeing you at your visit!

Clinical Intake Form – Adult (Age 18+)

Clinical Intake Form – Child & Adolescent (Age 3 to 17)

Patient Registration (Child/Adult)

HIPAA Rel of Information (Child/Adult)

Patient Privacy Notice (Child/Adult)

Medication History Authority (Child/Adult)

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ADHD Testing / Brainwave Scan

NEBA ADHD Testing (Using EEG Brainwave Scan)

o FDA Approved (Age 6-17 years)

o Procedure Takes 10-15min of Brainwave Data gathering

o Quick, Convenient & Friendly Process

o Results Available in 24 hours with upto 96% Accuracy

o For New Diagnosis or To Confirm Previous ADD/ADHD if You Are Concerned About Medications (Concerta, Adderall etc.)

o Option To See Psychiatrist Dr. Mirza To Optimize ADD/ADHD Treatment

o Cost $425 (total out of pocket expense)

    Accepting New Patients

    Schedule Video Visit

    Telehealth Appointment Request (All visits are online)See Dr. Mirza over video visit. Covered by insurance and avoid trip to office.

    ADHD, Autism, Bipolar Disorder, Depression, Anxiety

    Diagnostic evaluations for broad range of Psychiatric/Behavioral Disorders. Please see Clinical Services section for full list of conditions.

    Office Hours & Location (CLOSED TO PUBLIC DUE TO COVID-19 PRECAUTIONS)

    7505 Capital Drive
    Germantown TN 38138
    Office: 901-730-0575
    Mon 09:00am - 05:00pm
    Tue closed
    Wed closed
    Thu 09:00am - 05:00pm
    Fri 09:00am - 04:00pm
    Sat closed
    Sun closed

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