Forms

Westfield Psychiatric Wellness Center participates with Blue Cross/Blue Shield, Aetna and Cigna. We do not accept Medicaid or Medicare.

If you don’t have the above mentioned insurances and would like to know our out of network benefit costs, please contact us directly.

Our Services

Credit Card Authorization

Download the credit card authorization form, fill it out, and bring it to your appointment.

Credit Card Authorization

All forms must be filled out online and must be done 24 hours before the appointment.

Adult Forms:

Westfield Registration Form
Westfield Adult Self Report
Policies and Procedures
HIPAA Part 1
HIPAA Part 2
Covid Policies and Procedures

Under 18 Forms:

Westfield Registration Form
Parent Checklist of Symptoms
Adolescent Self Report
Policies and Procedures
HIPAA Part 1
HIPAA Part 2
Covid Policies and Procedures

Schedule Appointment

Take the next steps to your path to wellness. Make an appointment for a psychiatric consultation with a prescriber please call 908-233-8065.