Provider: Marie Akers, DNP, APRN, PMHNP-BC, PPCNP-BC, PMHS
25200 Sawyer Francis Lane, Suite 135, Lutz, FL 33559
Phone: +1 (813) 592-7228 | Fax: +1 (813) 537-8744
Before You Begin
Prescreening Instructions
Please complete this brief prescreener to help determine whether
SHIELD Psychiatry PLLC may be an appropriate clinical fit for you or your child.
This form is for patients ages 5–25.
For patients ages 5–17, a parent or legal guardian should complete the form.
Patients ages 18–25 may complete it independently.
Important: This prescreener is not for emergencies.
If there are urgent safety concerns, call 911, contact
988, or go to the nearest emergency department.
