Psychiatric Medicine Associates Psychiatric Medicine Associates
New Patient Application Form

New Patient Application Form

PMA providers are contracted with Regence and Premera. Patients who have other insurance companies may send in their statements to receive out-of-network benefits based on their plan. Therapist Dr. Kim Pentel is not contracted with insurance carriers at this time and is accepting self pay patients. 

Please fill out the form in detail and we will get back to you via email with further instructions. Our providers are accepting patients on a case by case basis and endeavor to make sure they are a good fit for your needs. 

Name *
E-mail *
Phone Number *
City and State of Residence *
Select an Option *
PMA takes Premera, Regence or self-pay, please select an option *
Have you been hospitalized for a mental health issue in the last 6 months? *
Are you under a court order to see a mental health provider? *
Have you had any suicide attempts *
Do you engage in self harm? *
Are you switching from another provider or seeking services for the first time? *
List Any and All Mental Health Diagnosis or Issues You Are Dealing With *
If switching providers please explain the reason. *
List all medications you are currently taking. *
Describe the type of provider and services you desire *
After reviewing this form we will email you the next steps. The review process can take up to 7 days. *

From Our Doctors

"It is a great privilege to be a psychiatrist. Psychiatry is a medical specialty that still emphasizes the crucial importance of a healing..." Read More

- Dorcas Dobie, MD, Seattle, WA

View All Testimonials

Recent News

We at Psychiatric Medicine Associates share in the collective grief and anger over the murders of George Floyd, Breonna Taylor, Ahmaud Aubery, Manuel Ellis and so many other members of the Black community who have lost their lives to senseless...

Black Lives Matter

by: Ashley Bouzis | Jun. 05, 2020

We at Psychiatric Medicine Associates share in the collective grief and anger over the murders of George Floyd, Breonna Taylor, Ahmaud Aubery, Manuel Ellis and so many other members of the Black community who have lost their lives to senseless...

Read More
Many of our patients are inquiring about whether they should be obtaining a

Genetic Testing

by: Peter Roy-Byrne | Jan. 23, 2019

Many of our patients are inquiring about whether they should be obtaining a "genetic test" to help select the best antidepressant for them.

Read More
Sometimes it can feel like a partner's low mood is contagious. We can take our stress home with us after a challenging day at work, or feel irritable or withdrawn for a variety of reasons, impacting the moods of other family members.

Depression and Your...

by: Christine Paprocki | Jan. 03, 2019

Sometimes it can feel like a partner's low mood is contagious. We can take our stress home with us after a challenging day at work, or feel irritable or withdrawn for a variety of reasons, impacting the moods of other family members.

Read More