SHIELD Psychiatry PLLC
Protecting Young Minds. Empowering Futures.™
Ages 5–25 • Florida Psychiatry
Confidential Clinical Screening
Mental Health Prescreener
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Approximately 5–7 Minutes |
Private & Secure |
Personally Reviewed |
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!
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This form is not monitored in real time
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Completing this prescreener does not create a provider–patient
relationship or guarantee acceptance into care. Responses are reviewed
to determine clinical fit and the appropriate next step.
SHIELD Psychiatry PLLC
Protecting Young Minds. Empowering Futures.™
Ages 5–25 · Florida Psychiatry
Start Here
Complete the New Patient Prescreener
Every new patient begins with the same brief, secure prescreener.
You do not need to choose insurance or self-pay before completing
this form.
One form. One starting point.
After the prescreener is reviewed, eligible families will receive
instructions for the appropriate intake, payment, insurance, and
scheduling pathway.
How the Process Works
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1
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Complete the secure prescreener below Tell us about the patient’s needs, current concerns, location, and requested services. Most families finish in approximately 5–7 minutes. |
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2
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SHIELD Psychiatry reviews the information The responses are reviewed to determine clinical fit, level of care, requested services, and the appropriate next step. |
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3
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Approved patients receive intake and scheduling instructions If SHIELD Psychiatry is an appropriate fit, you will receive the intake packet and instructions for Headway insurance or concierge self-pay before scheduling. |
Choose Your Payment Pathway After Approval
Both care pathways begin with this prescreener. If approved to
continue, select the option that best fits your family.
Insurance Through Headway
Use Headway for eligible in-network psychiatric visits, insurance
verification, and estimated patient responsibility.
Optional: Check Headway Insurance
Concierge Self-Pay
Choose transparent self-pay care directly through SHIELD Psychiatry.
Payment and authorization instructions are provided after approval.
Some specialty services may remain self-pay even when insurance is
used for psychiatric visits.
Opening the Secure Prescreener
Enter the patient’s full name. For patients younger than 18, use the
parent or legal guardian’s email address. Patients age 18 or older
should use their own email address. A security code will be sent to
that email before the form opens.
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Complete the secure prescreener below