Katherine Chemodurow Kelley, MD
IMPORTANT NOTICE: All patients will be transitioning to the AdvancedMD Patient Portal on Thursday, June 1st, 2023. Patients will still be able to message their providers and office staff, pay their bills, and access important documents through the AMD patient portal.
Please visit our FAQ page with links and resources to assist patients during this transition.
Katherine Chemodurow Kelley, MD
Printable Forms & Information
New Patient Registration Form (Printable)
Note: You can fill out these forms online here.
Online Forms
Instructions For Minor Patients with Custody Agreements
For minor patients with 2 or more unmarried guardians, Lifestance Health will need to have appropriate custody paperwork before treatment can occur. Please click here for more information on custody agreements and specific legal forms needed.
You may upload these forms on your patient portal, or through the secure upload form below. Please contact the intake department if you have any questions or concerns.