Request appointment | Sunshine Psychiatry & Wellness, PLLC

Thank you for your interest in Sunshine Psychiatry & Wellness. Before requesting an initial consultation, please complete this brief prescreening form. Your responses help determine whether the services offered through Sunshine Psychiatry & Wellness may be a good fit for your needs. This form is not a comprehensive psychiatric evaluation, and submitting it does not establish a treatment relationship or guarantee acceptance for care. Please do not use this form for urgent or emergency concerns. If you are experiencing an immediate mental health emergency or believe you may act on thoughts of harming yourself or someone else, call 911, call or text 988, or go to the nearest emergency department. What brings you to seek psychiatric care at Sunshine Psychiatry & Wellness at this time?

Limited to 600 characters

Which areas are you hoping to receive support for?

Select all that apply.

What symptoms or concerns are affecting you most right now?

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What are you hoping to achieve through treatment?

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Are you currently receiving mental health treatment or psychiatric care from another healthcare professional?

If yes, please indicate the name of your psychiatrist and/or therapist.

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Are you currently participating in, or have you completed within the past 90 days, a higher level of mental health or substance use treatment?

No Currently hospitalized or inpatient Residential treatment Partial hospitalization program (PHP) Intensive outpatient program (IOP) Recently discharged from a psychiatric hospital or inpatient program Recently completed residential, PHP, or IOP treatment Other

Are you currently experiencing thoughts of suicide, wishing you were dead or would not wake up, or thoughts of harming yourself in any way?

Yes, without intention or plan Yes, with intention or plan No

Are you currently experiencing thoughts of harming or killing someone else?

Yes, without intention or plan Yes, with intention or plan No

Are you currently experiencing symptoms that make it difficult to distinguish what is real from what may not be real?

Yes No Unsure

Are you currently seeking treatment primarily for alcohol or substance use?

Yes No

Are you seeking any of the following services?

Is your participation in psychiatric care currently required or requested by a third party?

No Court or legal system Probation or parole Attorney Employer Professional licensing board School or university Disability insurer Other

Are you specifically seeking continuation or initiation of a controlled medication?

Completion of a consultation does not guarantee that any particular medication will be prescribed. Treatment recommendations are individualized and based on Dr. Wragg's clinical assessment and prescribing policies.

No Yes, stimulant medication for ADHD Yes, benzodiazepine medication for anxiety or sleep Yes, another controlled medication

Is there anything else you think would be helpful for us to know when reviewing your appointment request?

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Request an appointment