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About Us
Frequently Asked Questions
Our Services
Adult Psychiatry
Children & Adolescent Psychiatry
Transcranial Magnetic Stimulation (TMS)
Veterans Mental Health Services
Cognitive Behavioral Therapy (CBT)
Psychodynamic Therapy
Eye Movement Desensitization and Reprocessing (EMDR) Therapy
Senior Support
Conditions we treat
ADHD
Anxiety
Depression
OCD
Nutrient Deficiency
Personality Disorders
Process Addiction
Our Team
Shashita Inamdar, M.D., Ph.D., DABPN
Rachel Watters, PA-C, MHA, MPH
Deven Parlikar, Chief Business Development Officer
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Provider Referral Form - Achieve Premier
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Provider Referral Form
Referral Health Form
Referring Medical Group Name
Provider Name
Patient First Name
Patient Phone
Provider Email
Patient Last Name
Referring to
- Select -
Therapy
Spravato (Esketamine) Therapy
Patient is Exploring Options
Psychiatric Evaluation
TMS
Provider Phone
Patient Email
Patient Conditions (Select all that apply)
Depression
ADHD
Bipolar
Anxiety
Stress Management
PTSD
Family Issues
LGBTQIA+
OCD
Substance Use
Wellness
Other
Additional Comments
This is a medical referral form for providers to submit patient referrals. If you need assistance, please contact (858) 221-0344 or email coordinator@achievepremier.health. When emailing, include the patient’s first and last name in the subject line for proper processing.
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988: Call or text the National Suicide Prevention Lifeline for 24/7 emotional support.
911: If you’re having a medical or mental health emergency, call 911 or go to your local ER.
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About Us
Home
About
Contact us
Our Services
Adult Psychiatry
Therapy
Transcranial Magnetic Stimulation (TMS)
ADHD Treatment
Depression Treatment
OCD Treatment
Senior Support
Contact Info
+1 (787) 665-9415
coordinator@achievepremier.health
