Encino Psychiatrists
Encino Psychiatrists Karen L. Vause and Ramzi Kiriakos
Encino Psychiatrists
16550 Ventura Blvd.
Suite 212
Encino, CA 91436
Direct Contact Information
Karen Vause, MD (818) 995-0640
Ramzi Kiriakos, MD (818) 881-8208
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Office Policies

Prior to your first assessment and treatment, there are certain forms to complete that are required by law or our office policies.

Please download the patient Intake form, complete them and bring them to your first appointment. If you cannot obtain them from our website, we will provide them to you when you come for the first visit. You may need up to 15 minutes to fill the New Patient Intake Packet.

Our New Patient Intake Packet contains:

  1. Registration - for a minor (less than 18 years), parental signature is required.
  2. Consent to Treat
  3. Authorization for Release of Information. You may wish to name a significant other or your physician(s)
  4. Credit/Debit card information
  5. Offices Policies and Procedures
  6. Acknowledgement of the receipt of the Private Practices Acknowledgement (HIPAA)

Download New Patient Intake Packet

Dr. Ramzi Kiriakos Patient Intake Packet (PDF)      |      Dr. Karen Vause Patient Intake Packet (PDF)