LIVE TRAFFIC CAM Click on the Traffic Light Icon for real-time imagery of traffic on I-285 at Chamblee Dunwoody Rd. before you leave for your appointment.  The caption under the image indicates whether the camera is currently pointing East or Southeast (towards I-85), or West (towards GA 400 and I-75). HCFA-1500 HEALTH INSURANCE CLAIM FORM Patients who intend to file with their insurance carrier for out-of-network benefits are sometimes required to use the HCFA-1500 Health Insurance Claim Form.  This form was originally developed by the Health Care Finance Administration (HCFA) and is now virtually universal.  Click on the Printer Icon to obtain a printable version of the HCFA-1500 form.  Instructions for completing the form should be obtained from the insurance company that administers your plan. FORM AUTHORIZING DISCLOSURE OF MEDICAL INFORMATION It is important for doctors and therapists to communicate among themselves when sharing the care of a patient, and records of treatment by previous psychiatrists, psychologists and therapists are often needed to complete an evaluation.  In addition, the doctor may request your consent to speak with family members and others.  Information regarding your treatment is confidential and priveleged, and all these situations require your written authorization.  Dr. Rivers-Bulkeley has provided a printable form for this purpose that can be obtained by clicking on the Cadeuceus Icon.  Please refer to the Patient Privacy Protection Advisory on the "Appointment Information" page of this website for further information. ONE MONTH MOOD CHART It is very helpful to keep a chart of your mood state over time rather than try to rely on memory.  The chart provides an objective record that documents patterns or cycles, spontaneous changes and the effects of medication.  Dr. Rivers-Bulkeley has devised this simple and easy to use chart that tracks elevated mood, depressed mood, anxiety, irritability and sleep.  Click on the Masks Icon to obtain a printable One Month Mood Chart,  For each day of the month, the user places an "x" in the appropriate box for prevailing mood, anxiety level (if any), degree of irritabilty (if any) and hours of sleep the previous night.  Notes regarding any contributing events, other observations or medication changes can be written on the back of the page.  Remember to bring the completed chart to your appointment!

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