Mark Herbst, MD

Psychiatry, Psychopharmacology and Addiction Psychiatry


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Mark Herbst MD
10642 Santa Monica Boulevard
Suite 202
Los Angeles, CA 90025
Tel:310.207.8880 Fax:310.826.7077
[email protected]

Helpful Forms


If you're a new patient, please complete the following forms and bring them to your first session.

  • New Patient Questionnaire
  • Consent for Treatment
  • HIPAA Authorization Form

If you would like me to coordinate care with another provider (for example, primary care physician, etc.), complete this form to authorize release of your psychiatric information:

  • Release of Medical Records Form


Note: To download Adobe Acrobat Reader for free,
click here.


Disclaimer
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