Medication Checklist

Patients don't always remember the medications they've tried in the past. Use this handy checklist to help them identify previous medication trials.

Patient Election to Self-Pay

If your practice accepts both cash pay and insurance, and your patient is electing to pay out of pocket for a service, cover all your bases and have your patient sign this form

PHQ-9 Depression Screening

Here's a standard PHQ-9 Depression Scale in a PDF format that you are welcome to download, print, or use as a template in your electronic health record (EHR).

TMS Therapy Exclusion Criteria

Present this standard TMS Therapy Exclusion Criteria Form to your patients during the TMS Consultation or build as a template into your existing EHR.

TMS Session Progress Notes

It is recommended to always obtain medical records to ensure patient safety and satisfy any requests for medical records by the patient's insurance provider.

HIPAA Privacy Notice

Customize this HIPAA Privacy Notice to your TMS clinic or psychiatry practice. Patient acknowledgment is required before the start of TMS therapy and/or each visit.

TMS Patient Intake Form

Our standard TMS Physician Order is a simple fill-in-the-blank order that can easily be used by any TMS clinic. Note: Most insurances require that the order for TMS be written by a Psychiatrist.

Patient Acknowledgment of Non-Covered Services

Maintenance TMS is not typically covered by health insurance plans. Be sure that your patients receiving maintenance or other treatments sign this form.

Patient Acknowledgment of Non-Covered Diagnosis

Customize this HIPAA Privacy Notice to your TMS clinic or psychiatry practice. Patient acknowledgment is required before the start of TMS therapy and/or each visit.

TMS Physician Order

Our standard TMS Physician Order is a simple fill-in-the-blank order that can easily be used by any TMS clinic. Note: Most insurances require that the order for TMS be written by a Psychiatrist.

TMS Session Paper Progress Note

When you're in a pickle, print this paper form to use as documentation of a mapping or re-mapping session. For clinics without an EHR, use this form to document your patient assessment.

Motor Threshold Determination Log Sheet - Neuronetics Only

Use this handy MT Determination Sheet during a TMS mapping session and upload to the EHR or to document parameters in your physician note

SOC Treatment Room Log

Use this Start of Care (SOC) Treatment Room Log for a quick glance of your patients overall progress. This is a great tool for the technician to use to identify when it may be necessary to collaborate with the physician.

TMS Clinic Supply Request Form

Use this Supply Order Checklist to submit to your Office Manager or TMS Coordinator when you need extra supplies for your work area or TMS treatment room.

Patient Survey (Last TMS Session)

The only definitive way to optimize your services and the patient experience is to consistently offer all patients a Patient Survey at their discharge consultation.

Revocation of Self-Pay Form

If your patient previously elected to self-pay for treatment and now wants their insurance to be billed, they should complete a Revocation of Self-Pay

Patient Request for Medical Records

This Request for PHI Form should be used when a patient requests for their own medical records whether for their use or to be sent elsewhere

Individualized (Off-Label) Use Consent for TMS Therapy

It is a good idea to use an Individualized (Off-Label) Consent for TMS treatment for patients receiving a non-FDA approved treatment protocol.

TMS Clinic Application for Employment

Customize this Application for Employment simply by adding your clinics business name. We recommend that all employee files have an application on file, regardless of who the employee may be (family member, etc.). Simple, sensible, and smart.

Pre-Employment Background Check Authorization Form

All employees working in direct patient care areas should receive a background check. While this step in the employment process may extend the hiring period for a few days it is well worth it to prevent any issues later down the road.

Personnel Change / Action Form for Employee File

When employee pay, title or position, or termination occurs, it is recommended to keep track each of these personnel changes and maintain in the employee file for access later if needed..

TMS Technician Job Description



Feel free to use this sample TMS Technician job description for use when posting an open position, as well as providing your employee a job description.

TMS Clinic Medical Director

Job Description

Our sample TMS Medical Director job description is comprehensive and includes the most important job responsibilities for this position. A Medical Director is typically paid as an employee.

Personnel Change / Action Form for Employee File

When employee pay, title or position, or termination occurs, it is recommended to keep track each of these personnel changes and maintain in the employee file for access later if needed..

TMS Clinic Start It Up!™

Checklist

Check out this handy TMS and Psychiatry Clinic startup checklist and make sure you've taken care of all the necessary steps for a successful startup. Doing things the right way the first time around will save you the burden of huge headaches in the future.

TMS Clinic Start It Up!™ Powerpoint Presentation

This handy presentation will help guide you with all the nuts and bolts of a business plan and provides answers to some of the most common questions we receive from existing clients. The content will help streamline a successful startup process.

Business Associate Agreement - Blank

A Business Associate Agreement, is a written arrangement that specifies each party's responsibilities when it comes to PHI. HIPAA requires covered entities to only work with Business Associates who assure complete protection of PHI.

TMS Clinic Start It Up!™

Training Session #1

Patient identification, consultation, and scheduling.

TMS Technician Role, Mind Your Mental Health Therapy, & Patient Discharge Follow-Up Process

TMS Clinic Start It Up!™

Training Session #3

10 Simple, Sensible, Smart, TMS Clinic Marketing Solutions for Thriving TMS Clinic

Assisting your patients to recognizing unhealthy thought patterns is the first step toward positive change. This tool will help your patients label their unhealthy thought patterns.

Anxiety Series:  Fear & Avoidance

As a person dealing with anxiety, and even panic, you may already be familiar with fear and acting out of avoidance. Use this tool to help your patients identify with their fears.

Anxiety Series: Components of Anxiety

Anxiety is a physiological state characterized by cognitive, somatic, emotional, and behavioral components. Assist your patients with identifying the component of their anxiety.

Anxiety Series: Origin of Anxiety

Identifying the origin of anxiety helps to facilitate discussions. This tool will help your patients to determine the source of their anxiety.

Anxiety Series:  Anxiety with People

Anxiety can occur with a specific individual(s). This tool will assist your patient to identify with the thoughts and feelings they have with specific individuals.

Anxiety Series: Physical Symptoms of Anxiety

Anxiety can cause a number of physical symptoms. This is a great tool for your patients to use to identify the physical symptoms that may be associated with their anxiety.

Depression Series: Physical Symptoms

This is a great weekly tool that you can encourage your patient to use to chart their daily mood. This will also help the TMS technician to monitor for an improved mood during the course of TMS treatment.

Depression Series:  My Negative Thoughts and Emotions

Use this thoughts and emotions tool to help your patients become more mindful of their negativity. Then, provide them to tools to replace those negative thoughts with a positive cognition.

Depression Series: List of Coping Thoughts

Help your patient to begin learning more effective ways to cope. Here's a great list of coping thoughts that your patient can review and begin to replace those negative thought patterns.

Depression Series: List of Emotions

This tool is a comprehensive list of both positive and negative emotions. We suggest that you have your patient use a new tool each week to document the emotions they identify with throughout the week. Look for improvement and document the findings.

Depression Series:  List of Coping Thoughts

Sometime patients need to be encouraged to learn effective coping skills. Use this comprehensive list of effective coping thoughts to guide your patient to cope more effectively.

Depression Series: Negative and Positive Cognitions

Sometime patients may not recognize the difference between a negative and positive cognition. This tool can help them to identify their negative cognition and provides examples for a positive replacement.

Depression Series: Clarifying Values

Help you patient to clarify which values are important to them. This tool provides a list of some of the most common things that people value.

Depression Series:  Sleep Diary

Sleeping problems is commonly experienced with depression. This tool will help your patient to monitor their quality of sleep as they move through their TMS treatment sessions.

Depression Series: List of Fun Activities

When someone has experience depression for a long period of time their quality of life is often poor without activity. Here's a list of fun activities that you can include in your discharge packet.

Depression Series: Symptoms of Stress

Symptoms of stress often go hand-in-hand with depression. Use this tool to help your patient identify with any symptoms of stress they may be feeling.

Depression Series:  Relationship Satisfaction

Depression not only affects the individual, but can often lead to poor relationships with others. This tool will help your patient to document their perception of satisfaction with family members and friends.

Depression Series: Goals

Help your patient to set a new goal each week as they move through their TMS treatment. Achieving goals brings about a sense of accomplishment. This tool provides them a simple way to document their goal.

Self Esteem Series: Ways to Build Self Esteem

Low self esteem is a common symptom in many people with mental health conditions, especially depression. Use this tool to help your client identify ways to build their self esteem.

Self Esteem Series: Building vs. Destroying

A person may suffer from low self esteem for many reasons. Help them to recognize things that build vs. destroy how they feel about themselves.

Self Esteem Series: Self Confidence Diary

This is a great tool to help promote a healthy self esteem in your patients. Everyone has gifts and positive things in there life, you can help them identify them.