Schedule an Appointment
To schedule an appointment, click here or call 432.620.1160.
Services
0 to 3 years old = infant services
3 - 17 = child and adolescents
18 < = adult
Children & Adolescents must be accompanied by a parent or guardian. Guardians must provide proof of guardianship, power of attorney documentation, or proof of custodianship.
Therapist and doctors work closely with guardians to determine the needs and expectations
for sessions. Each session may vary in the participation parents or guardians play
in the therapeutic process.
A team of specialist will provide a customized treatment plan to enhance the care
and outcomes of patients. Doctors and therapist work together to ensure the proper
and effective combination for healing and treatment.
Documentation needed for a new patient appointment:
1. ID
2. Insurance (front and back)
3. New patient paperwork (Adult or Child)
Once you’ve completed the new patient paperwork, please return these items by:
Email: psychconsult@ttuhsc.edu
Fax: 432.620.1156
In person at 2301 W. Michigan Avenue, Midland, TX, 79701
Once all information and documentation received, a Texas Tech representative will contact you to schedule an appointment. A patient is considered new and would have to complete the new patient information if 3 years amount of time has elapsed since your last visit.
New Patient Forms
Dr. Rila Checklist for Children (for parent)
Dr. Rila Checklist for Adolescents (for child)
Release of Information - Psychotherapy
Release of Information - Medical
Dr. Jain New Patient Form for Child
Dr. Jain New Patient Form for Adult
Consent to Treat (Spanish Version)
Consent to Treat (English Version)
Consent to Treat (Telemedicine)
Office Appointments
New patient appointments are scheduled for sixty (60) minutes and follow-up appointments are scheduled for thirty (30) minutes; if seeing a counselor all appointments are 60 mins.
We ask that you arrive fifteen (15) minutes early for all appointments.
If a referral is required by your insurance, you are responsible to obtain and maintain the referral from your primary care physician.
You are responsible to pay any expenses incurred that are not covered by your insurance.
Patients are expected to pay before services are rendered.
Confidentiality
Your medical information is held in strictest confidence. Patients receive information called Notice of Privacy Practices when they visit a clinic for the first time. This sheet explains patients’ rights regarding Protected Health Information and how TTUHSC may use and disclose this information. The notice is also available from the Privacy Office or at https://www.ttuhsc.edu/compliance/hipaa/.
We value your privacy and we ask you to do the same. Please remember to keep any information you see or hear in the clinic confidential.
Texas Tech Psychiatry Accepted Insurance Providers & Payment Options:
• Self Pay
• Most major insurances
• Medicare & Medicaid
OFFICE HOURS
Monday—Thursday
8:30am-7pm
2301 W. Michigan Ave.
Midland, TX 79701
432.620.1160
432.620.1156 Fax
For more info contact pbpsychadmin@ttuhsc.edu