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JoEllen H. Butler

JoEllen H. Butler JoEllen H. Butler JoEllen H. Butler

480-787-9384

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    • Home
    • Forms/Policies
    • Fees & Services
    • Calendar
    • Emergency Resources
    • Books
    • Contact

JoEllen H. Butler

JoEllen H. Butler JoEllen H. Butler JoEllen H. Butler

480-787-9384

  • Home
  • Forms/Policies
  • Fees & Services
  • Calendar
  • Emergency Resources
  • Books
  • Contact

Forms

New patient Paperwork

Authorization for Release of Information (ROI)

Authorization for Release of Information (ROI)

 The electronic version of our new patient paperwork is currently being updated. Please check back soon.


A printable version is available below - once completed, please scan and email it to joellenbutlerpsynp@gmail.com.


All new patient appointments are conducted by video via Doxy.me. New patient paperwork must be completed before your appointment can be scheduled.


A follow-up appointment is required 2–4 weeks after your initial appointment to become established.

Authorization for Release of Information (ROI)

Authorization for Release of Information (ROI)

Authorization for Release of Information (ROI)

Authorization for Release of Information (ROI) to and/or from the office of JoEllen Butler.



Authorization Form

New Patient Paperwork (pdf)

Download

ROI Form (pdf)

Download

Notice of Privacy Practices (pdf)

Download

OFFICE POLICIES

To help keep costs down, this practice is strictly self-pay and does not accept insurance of any kind. Upon request, we can provide a superbill you may submit to your insurance carrier for possible out-of-network reimbursement; reimbursement is not guaranteed. 

Emergencies
The after-hours line is for emergencies only. If you require immediate medical attention, please dial 911 or the 988 Suicide & Crisis Lifeline.

If you are not experiencing an emergency, please contact the office at 480-787-9384 by phone call or text message. We will respond within 1-2 business days.

Prescription Refills
All prescriptions are e-prescribed directly from our office to your pharmacy. Please check with your pharmacy first to confirm whether a refill is already on file before contacting our office. We strive to complete refill requests as quickly as possible; requests made outside business hours will be addressed on the next business day. Since Monday is typically our busiest day, a request made over the weekend may not be completed until Monday or Tuesday.

Prior Authorizations

Prior authorization requests may take a week or more to complete.

Cancellations & No-Shows
We require at least 24 hours' notice to cancel or reschedule an appointment. A $50.00 no-show or late cancellation fee applies to missed appointments and must be paid before scheduling another appointment.

Appointment Reminders
Appointment reminder text messages are automated. Do not reply to these — we will not receive your message. If you need to cancel, reschedule, or you received a reminder text in error, please contact the office directly by phone or text at 480-787-9384.

Tips to Help Things Run Smoothly

  • Make sure we have your current pharmacy information: address and phone number.
  • Let us know about any changes to your insurance for prior authorizations.
  • Schedule your follow-up appointments as directed to keep refills on a regular schedule.
  • When contacting our office, please include your full name and date of birth so we can verify your identity. We ask for this each time to help protect your privacy. 

Copyright © 2026 JoEllen H. Butler NPPC  - All Rights Reserved.

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Hello!

Starting 8/17, the fee for med-check/follow-up appointments will be $120.00


JoEllen Butler is a self-pay providers office and does not accept insurance.


Communication will be answered/returned within 24-48 hours during business hours.


Thank you!