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Meet Ken, your trusted billing specialist in Arizona! With a background in psychiatric billing, Ken is dedicated to optimizing your care. Conoce a Ken Request an appointment

Dr. Bre Chamoff, DNP, PMHNP-BC, specializes in pediatric psychiatric care with a focus on trauma, ADHD, and brain-gut connections. Offering compassionate care to children, adolescents, and young adults across Arizona. Now accepting new patients Dr. Bre Chamoff, DNP, PMHNP-BC, CPNP-BC Bre (like the cheese) Chamoff (She/Her) is triple board certified in pediatric primary care, pediatric critical care, and psychiatric mental health. She has been a nurse practitioner for over a decade working in various pediatric settings. She is passionate about care for kids, adolescents, and young adults. Her prescribing philosophy is meds are not first line, unless they absolutely need to be. The team effort between provider and patient is to get that spark back, let your beams shine bright, and use all options to get there. She commonly says her “drug of choice” is human connection, and this certainly bodes well for fostering a team approach with her patients to make a plan that suits them. Bre has worked in pediatric GI specializing in illnesses such as irritable bowel syndrome (IBS) and functional constipation and how those are experienced both physically and emotionally. She has a particular interest in brain-gut connections and the impact on mental health and behavior. She was also one of the first 2 nurse practitioners who started the pediatric trauma program at Queens Medical Center in Hawaii. She has since spent much of her time working inpatient at Flagstaff Medical Center on general pediatrics and in the pediatric ICU. She has a blunt and comical (mostly when appropriate) approach, because life is hard and no one gets out alive. Bre currently resides in Flagstaff, AZ. In her free time, you can find Bre Snowboarding , traveling to live music to any number of bands including Tool, Gojira, Daughter, Carina Round, Rainbow Kitten Surprise, System of a Down, Elton John, Bon Iver, Puscifer, Primus or Tim McGraw (to name an eclectic few), reading books galore, or begging her friends to play board games with her. She has a ’73 VW bus named Clementine (who sometimes starts and sometimes does not start, but Clementine’s charm is not dependent on her reliability, or the lack thereof) and a 8 yo Bengal named Ananda, who runs the show entirely. As you’ll note in Bre’s Q&A she is verbose and rarely lacking the words she needs to overly express her interests and ideas with many caveats and sidebars. She offers both an apology and congratulations for this. *only taking ages 5-15 on waitlist basis* Pediatric Mental Health Bre is an expert in pediatric mental health encompassing ADHD, autism, sensory procesing, mood, anxiety, and trauma. Medical With a background in acute pediatric care, Bre is an excellent resource for kids with co-existing medical conditions or gastrointestinal problems. Adolescent Mental Health Teenagers can be hard to connect with -- but they will appreciate Bre's humor and energy and may (well, hopefully) look forward to visits with her. Q&A What is your favorite movie? Of all time: Almost Famous; Disney: Emperor’s New Groove But to be fair my second language is movie quotes; I’d say I’m fluent. Favorite superhero? I always try to have a more unique one but the truth is, it’s Superman. I love that he’s just unassuming Clark Kent, then off saving folks, then back to glasses wearing, run of the mill Clark Kent. Big fan. If you could have a superpower, what superpower would you pick? Easy! I ask people this all the time! Teleportation. I could see all my favorite people anytime, travel to all live music, without leaving any carbon detriment, and minimizing travel time. Very efficient. Favorite bands/singer? Tool without question. But, music is my insides on the outsides. I love music so very deeply. I spend most of my spare time on live music, and traveling to live music. I am not personally musically inclined, but I am a big-time consumer for sure. I have a pretty wide array of likes. Indie. Folk. Bluegrass. Metal. Country. And that is certainly not the end of it. I collect vinyl because I like how it sounds despite its wild inconvenience. If you had 3 wishes, what would you wish for? Selfishly: (1) the ability to speak all languages fluently (2) to see a new and varied sunset in every place of the world (3) an eidetic memory (wish 3.5: Limitless quantities of Cinnamon Toast Crunch accompanied by free dental care for life) Broad and esoterically: -that every individual has a true inherent fundamental drive to first understand themselves, then understand others, and only then attempt to altruistically affect change. I read a bumper sticker yesterday that said “everyone is just doing their best…. And that is fucking terrifying” Hearrrrrrd that! What is your favorite food? Okay, are you asking what is my death row meal? Or what is my favorite day to day food? Because my death row meal is for sure next day spaghetti! don’t give me fresh spaghetti. Make it the day before, let it sit all night, and then microwave it- that’s my last meal! Day to day I have a gnarly sweet tooth. So on second thought back to the 3 wishes I think I’ll just take lifetime dental care. 😏 What are you most passionate about in the mental health field? Access to care for kids and adolescents. Offering a true partnership where the child is considered an active person with meaningful thoughts, feelings, and experiences. What are some experiences you have had that make you unique? My mental health nursing rotation in undergrad was in a study abroad program in Belfast, Norther Ireland. This was illuminating to see psychiatric care offered in a different and social model. I have a long strong background in pediatric medicine and that offers a robust amount of experience working with complicated pediatric illnesses. I went to 9+ schools as a child (not a military brat, just life circumstances) so adapting to change is a superpower I gained at a young age out of necessity. This just means I regard most strangers as “friends I haven’t met yet”. I went to Ecuador for 3 months to learn Spanish, then System of a Down went on tour so I came back early for a concert. Learning Spanish is still a life goal of mine. I own a 73 VW bus named Clementine. In an ideal world, she would be my traveling office (she breaks down too much, but I still love her). What is your philosophy on using medication to treat mental health for kids? I believe medicine, like many other things is a tool. I like to explain it this way: consider depression, anxiety, trauma, aggression, etc as broken glass on the ground. We can clean it up without tools like a broom, or without shoes on, but it’s messier and more difficult that way. Using the right tools is going to make it both easier and safer. Sometimes one shoe is therapy, maybe the other shoe is medicine, and maybe the broom is family dynamics. Medication is rarely the singular fix for anything (except for maybe in diabetes), it’s an adjunct for symptom management. It also can allow for healing to occur. Medication is not always forever, and its not always the right choice. It so situationally based, and more complicated than one blanket approach applies to all. Generally, I’m pretty conservative, but not afraid to consider meds when they are an appropriate tool. I am a firm believer in collaboration with my patients and parents. I won’t give teens a medicine they don’t want. Medicine is not the only option, I’m a big believer that work is often necessary when it comes to caring for our mental health, and that involves the whole family unit, nothing exists in a vacuum. Everyone is unique, sometimes we use all tools all at once, sometimes we try them on differently, it’s about the individual. I’m also a big proponent of natural and holistic remedies, but they are not without potential for harm themselves and I think it necessary to be mindful of risk and benefit of any and all interventions. We have to be mindful of all things that affect our neurochemicals, to include many things we forget to consider like caffeine, sleep, exercise etc. If a patient is nervous about an evaluation, especially when talking about tough things like trauma or sexual abuse, what would you want them to know? Getting to the deep dark stuff is one of the hardest things we ever do, so before you do it know this is a safe space without judgement. I won’t make any decisions about your care without you, you’re in control here. So, first know you’re not alone. Second, those experiences don’t define you. Sometimes healing is a process in patience; I ask that you be patient with you and all that comes up, and patient with this process as I walk alongside you through it. Sometimes we need to say “not today satan” and table that stuff, which is perfectly fine. Others we jump in, like I said, it’s a process. Most importantly that process isn’t always linear and that’s okay too. There’s a meme somewhere that says something like ‘sometimes life is messy, sometimes life is beautiful, most the time it’s both’. That feels a little too flowery for some of the deep dark shenanigans we go through, but at the end of the days it’s not total crap. Talk to us about working with divorced families, coparenting or families in turmoil? This can get dang hairy. in initial evals it’s important in my book to set the precedent and expectation. Both parents have to be on board, and while that’s often difficult, I feel good about being firm in support of this model. There’s no room for separate meetings or visits, playing ping pong between warring forces. I’m not generally a proponent of avoiding, or releasing families, solely due to parental conflict because the only person there who suffers is the child who can’t get the care they need. I’m willing to be a force when needed to facilitate the forward motion of care for the child. My initial approach is always attempting to understand the perception of each person, the intention of each and then collectively identify a common goal. If I’m right, and I hope I am, we’re all attempting to achieve what is best for the child. When there is an impasse, I tend to get direct and blunt singularly with parents. It’s important to be factual. This has been really effective historically. If you read this and feel you want to go on this wild ride with me, just know I can be spicy, but it’s in an effort to achieve a common goal. Do you have any personal experiences regarding mental health you are open to sharing? I am an open book but find the specifics to be more beneficially shared contextually. I wouldn’t want to wallop the world with my history on a website, but I’ve been through some doozies. My own “colorful” experiences if you will. It makes me feel really comfortable talking about legitimately anything. I often tell my patients there’s a slim chance I haven’t discussed anything you’re able to bring to the table, so hit me with it and let’s dive in. I also have an interest in non-traditional medicines, including the use of entheogens for further treatment and exploration of mental health disorders in future practice. Talk to us about the overlap of physical and mental health for kids. Physical and mental health aren’t entirely separate, and while our medical model and approach treats it that way, they are deeply integrated. It has been astounding to see how many kids are left untreated regarding mental health for an enumerate number of reasons. We live in an unprecedented time and continue to attempt to apply historical solutions to it. While that’s not fully unexpected as we have to go with what we know, we also have to ask ourselves how much of the mental health disparity that we see in adults could be mitigated if approached in childhood. On the other hand, I’m not a fan of pathologizing childhood behavior to made them more compliant to a world that expects them not to be kids: an approach at balance is the key (cliches are true for a reason). I think my experience with complex medical illnesses is going to translate well in terms of my ability to communicate and combine holistic care with both pediatric patients and parents. I also have a keen eye to ferret out medical and mental health causes separately and in conjunction. Do you have experience in working with non-binary and trans kids? Yes definitely! In fact, I originally chose endocrine as my area of specialty focus. So I started meeting with pediatric patients interested in delaying puberty at the onset of my career as a student NP. This was in 2013. Since then, I have encountered a wide array of patients across the spectrum of trans, non-binary, questioning, and more. I am a big proponent of self-expression and exploration. I am a big fan of helping my patients feel seen and actualized and sometimes that includes bridging the conversation with loved ones and being a support in that time. What are your thoughts on screen time and social media for kids and teens? I think a blanket statement here isn’t going to work. Like anything else, no absolute is the answer. I think when we fully restrict social media children/teens experience a sense of isolation, with full unabridged free reign they can experience any number of things including grooming or bullying, and can be the victim or perpetrator of such. I think with anything, active presence and engagement from the caregiver with mutually agreed upon structure and boundaries is going to be a solid approach. Too much of anything isn’t great. The stimulation of imagination to aid in the progression of developmental stages is best served with varied experiences, they cannot all be garnered from a screen. That is not to even touch on the secondary medical difficulties such as sedentary lifestyle leading to obesity and insulin resistance, and visual decline. With all of that in mind, never in my life have I said to a patient “okay 2 hours of screen time a day” and that happened. So instead, I ask families, would it be possible, once per day, when you go to watch TV, or look at the tablet or phone, you set a timer and do anything else that’s not screen related until the timer goes off (ironically said timer is typically on a phone screen, we can’t win them all). That’s a manageable task, and reduces it by a little. Small achievable changes are often the name of the game. My personal stance on screen time is it isn’t great, would love to decrease it. But my personal stance on going to the gym is that I should be going more, and I’m literally eating cheese its at 10:30 pm while I write this so life is messy and hard, and we have to make the goals achievable and do what we can!

Discover the leader behind Paperflower Psychiatry. Meet Dr. Maria Ingalla, DNP, PMHNP-BC providing expert mental health education and content creation. Dr. Maria Ingalla, DNP, PMHNP-BC Maria Ingalla, a certified nurse practitioner specializing in family psychiatric mental health, brings a wealth of experience in mental health from years working in community mental health agencies throughout the Valley. She frequently was argumentative with leadership over poor quality of care and the "pill mill" ideology that these companies depended on for money . After some unexpected exits from these past jobs (let's call them unplanned career detours), Maria decided it was time to start a company that had openly progressive values and focused on patients instead of dollars. Maria specializes in providing compassionate care for mental health challenges during the perinatal period. After her daughter suffered from serotonin syndrome from breastfeeding, she became an advocatefor educating others on recognizing serotonin syndrome in breastfeeding infants. In her previous role as a nursing instructor at Arizona State University, Maria taught pharmacology and mental health courses to nursing students in Bachelor's and Master's programs. Her dedication to education was recognized with a Daisy Award nomination for excellent faculty in Spring 2022. Maria has also made valuable contributions to the academic community at Aspen University. She continues mental health education to the general public on her Tik Tok account: @dr.mariaingalla Maria's extensive experience as a psychiatric consultant spans nationwide collaboration with pediatricians, primary care doctors, and OB/GYNs, focusing on the holistic management of mental health for complex patients. Her commitment to providing high-quality mental health care is evident in her multifaceted contributions to the field. Maria remains an advocate for social justice, and equity within the mental health system. Maria now mentors new graduates with similar ideologies to be your excellent practitioners within Paperflower. She is currently working on ways to continue educating new graduate nurse practitioners and the general public on psychiatry. Maria currently lives with her husband, two daughters, two dogs, Marshmallow and Potato. She used to enjoy a lot of things but let's be honest, now she's a mom and she doesn't have much of a life besides chasing around two small children. Contact: maria@paperflowerpsychiatry.com Mentorship As the owner of the practice, Maria ensures that she remains accessible to all of her practitioners to help them grow professionally. Education Maria currently develops continuing education programs for professionals as well as offering education for the general public via her podcast & social media. Child Psychiatry Maria is passionate about neurodivergence and child psychiatry -- previously before running Paperflower, she spent years managing medications in community mental health. Guest Episode on the Affirming Minds Podcast VoyagePhoenix Interview Guest Episode on Finding Arizona Podcast TikTok Cohost for Brain Trash: From DSM to Dumpster Fire Podcast WebMD Article on Bipolar Treatment Canvas Rebel Interview Paperflower Institute

Discover expert pregnancy recommendations in Arizona. From prenatal care to childbirth, find the best health resources for your pregnancy journey. Recursos perinatales Partería familiar primero Madeline y Jetta son matronas increíbles y con experiencia que te harán sentir cómoda y te ofrecerán la mejor atención que puedas pedir. Ubicadas en Goodyear y Scottsdale. Obstetricia y ginecología de primera línea, LLC El Dr. Hervey es conocido por ser uno de los mejores obstetras y ginecólogos del estado, y sus pacientes le han dado una respuesta fenomenal por su trato con los pacientes y su apoyo a los planes de parto de las pacientes. Su equipo es igualmente maravilloso. Embry Salud de la Mujer ¡Específicamente fantástico para el síndrome de ovario poliquístico, pero en general tiene excelentes críticas! Ubicado en Mesa. Mamá Doula AZ Lisa López ha sido la doula de María en dos partos y es INCREÍBLE. Tiene conocimiento sobre traumas, entiende la ansiedad y la depresión perinatal; es una gran persona y una doula increíble. Ofrece servicios de vendaje abdominal, instrucción de acondicionamiento físico, apoyo a hermanos, servicios de doula en duelo, apoyo en casos de aborto espontáneo y fotografía de recién nacidos. Innovaciones en salud de la mujer WHI ofrece apoyo a mujeres embarazadas, incluidos varios grupos de apoyo para mujeres embarazadas, en posparto y en duelo. Dra. Debra Wickman Obstetra y ginecólogo especializado en traumatología. Ubicado en el área de Camelback en Phoenix.

Looking for top psychologists in Arizona? We refer to only the best. Psychological & ASD Testing Psicología de la cima Ofrece pruebas integrales que brindan diagnósticos de autismo, trastornos del estado de ánimo, trastornos de la personalidad y también evalúan las capacidades cognitivas. Eje para el Autismo Ofrecen evaluaciones para el autismo para adultos y niños de hasta 12 meses. Aceptan algunos seguros y planes AHCCCS. Varias ubicaciones. Bienestar Choulet Ofrece múltiples servicios, pero lo más importante son las evaluaciones de autismo para adultos. Pago privado en Scottsdale. El grupo Nicholls Pruebas psicológicas (autismo, discapacidades de aprendizaje, superdotación, evaluaciones forenses, evaluaciones neuropsicológicas, evaluaciones para demencia) ubicadas en Scottsdale. Dra. Lauren Megrew Experto en neurodiversidad: ofrece evaluaciones de neurodiversidad, coaching de funcionamiento ejecutivo y otros servicios para parejas, padres e individuos que abarcan la neurodiversidad. Los servicios son virtuales. Dr. David Prince Ofrece evaluaciones de TEA ubicadas en Phoenix. El Centro Rubin Evaluaciones de autismo en Tempe y Scottsdale. Especialistas en psiquiatría infantil, adolescente y universitaria. Kemper & Asociados Evaluaciones neuropsicológicas que incluyen evaluaciones para TDAH, autismo, demencia, discapacidades de aprendizaje, lesiones cerebrales traumáticas... ubicadas en Litchfield Park. Psicología de la introspección Ofrecemos evaluaciones neuropsicológicas, evaluaciones de superdotación, evaluaciones de discapacidades de aprendizaje... ubicadas en Scottsdale. Clínica de memoria del sistema nervioso central Exámenes neuropsicológicos (que incluyen pruebas de TEA) ubicados en Goodyear, AZ. Servicios Psicológicos Vitality Evaluaciones de autismo para todas las edades en el norte de Scottsdale. Pago privado. Otros recursos de evaluación del TEA que puede consultar Centro de evaluación pediátrica de Arizona Autismo de Arizona Unido Profesionales de la Psicología Infantil y Adolescente Centros de neuropsicología de Arizona, LLC Centros de autismo de Bierman Servicios de comportamiento pediátrico Gentry

Learn about Paperflower Psychiatry's policies on medication refills, no-show fees, service policies, discharge criteria, and payment requirements. Ensure a smooth experience by understanding our guidelines on appointments, insurance, and medication handling. Policies Want to check in on some important policies on refills, attendance to appointments and all that stuff? We'll break it down. Refill Policy We require an appointment on file to complete your refill. We will send you enough pills to get to that appointment. If you have a balance on your account, you must set up a payment plan with a working credit card on file prior to receiving your refills. If you cancel or choose to not attend after receiving your refill without rescheduling, you will no longer receive refills until you are able to attend an appointment. If you have not completed labs as ordered, you may be denied a refill at your provider's discretion. If after a controlled prescription is filled, it is reported to be lost, accidentally disposed of, or in any other means not accessible prior to the follow-up appointment, refills will not be provided. If you have not been seen by a provider in the requested time frame for follow up (one month, two months or three months), we cannot send your refill We charge $10 for processing same-day urgent refill requests, and $15 for same-day requests on weekends + holidays. Refill requests take up to 72 business hours to complete. Please request in advance. example: requests made on a Friday will be completed by Tuesday example: requests made on a Friday will be completed by Wednesday if Monday is a holiday No Show Policy A "no show" constitutes as not attending your appointment, cancelling your appointment under 24 hours prior to your appointment time (even emergencies...sorry :-(), attending your appointment while driving or coming to your appointment 10+ minutes late. A no show fee for an evaluation is $120 if rescheduled and attended, or $300 if choosing to not reschedule A no show fee for a follow up is $120, even if on a sliding scale No show fees will be automatically charged to your card the same day as missing your appointment Refills and future appointments will not be made unless the no show fee is paid or put on a payment plan with timely payments made Service Policies In order to maintain your evaluation, paperwork must be completed 24 hours before your appointment or your appointment will be cancelled. Support team and billing messages (voicemails, texts and emails) will be answered within 72 hours. Medical record requests will be handled within 30 days of written request. You agree that we will not participate in any court cases that include our presence without a prior agreement and signed contract with the agency and your provider at $350+/hour. We do not do emergency or crisis care. These situations require calls to CRISIS or 911. Parents or guardians are required to be present for the duration of their child's appointment unless otherwise arranged in writing; otherwise this will be cancelled and subject to a "no show" fee. The child is required to be present for their appointment unless otherwise arranged in writing; otherwise this will be cancelled and subject to a "no show" fee. If you have not been seen in 8+ months, we require a full new evaluation. Medication Policies After your provider sends a medication, you are required to call the pharmacy to troubleshoot any insurance, quantity, or other concerns prior to contacting us. DO NOT DEPEND ON YOUR PHARMACY APP TO TELL YOU IF WE SENT A MEDICATION - more often than not, we sent it! Call your pharmacy if it says the medication isn't ready (it probably has nothing to do with us). Medications other than psychiatric medications will not be provided by us. Medications that require blood work such as mood stabilizers are not guaranteed to be filled unless blood work has been completed. Medications can only be sent to pharmacies in the state of Arizona unless your provider holds an alternative state license. We will not prescribe psychiatric medications if you choose to have two psychiatric providers - this is not a safe arrangement You may be requested to sign a "controlled substances" policy if prescribed a stimulant or other controlled medication. Prior authorization requests can take 5-7 business days to complete. We will not prescribe benzo's (xanax, ativan, etc) unless it is (1) for a short term situation such as a flight/funeral/etc (2) you come in already taking one and create an agreement with your provider to taper from it We will not prescribe or continue your non-psychiatric medications (antibiotics, thyroid meds, etc) Discharge Policy Grounds for discharge includes: Refusal to work with our support team or any disrespectful, racist, vulgar language toward our support team. Choosing to have another provider fill or change your psychiatric medications without first notifying your Paperflower provider (it's not safe!) Dishonesty in regards to, selling or misusing medication prescribed Failing to show up (or a "no show") 3+ times for your appointments Refusal to create a payment plan for balances due Refusal to maintain a credit card on file (it's just how our system needs to flow with as many appointments daily we have..) Refusal to follow up as recommended by your provider Disrespect, harassment or vulgar language towards your provider Dishonesty in regards to custody situations or legal matters A patient outside of our expertise or scope of practice ---- In cases of discharge, we will send three referral sources for a new provider and a 90 day supply of medication if the medication is noted by provider to be safe to refill. Policy on fees/insurance We are a fee-for-service company, and do charge fees for paperwork, medical record requests and time outside of appointments. Updated fees can be found on services page. These fees will be charged to the card on file. If you have paperwork, it will be charged before paperwork is filled out or processed. We require everyone to have a working credit/debit card on file in order to keep your appointment. You are required to have a credit card on file even if you have an HSA/FSA card on file. You can write to have the HSA charged first. If there is not money loaded prior to your appointment and other arrangements are not made, the credit card will be charged. All fees/copays/deductibles are collected 24 hours prior to your appointment. If your payment does not go through prior to the appointment and you have not made other arrangements with support (to update card, a day you get paid, payment plan etc), your appointment will be canceled. If you do not have updated insurance information within 24 hours of your appointment, that visit may be charged as a self pay rate. For medications to be sent or paperwork to be completed, if there is a balance on the account, we require a payment plan in place with a down payment. Refunds are not issued in any circumstance if the service has already taken place. A sliding scale is arranged with a single provider. If you chose care with another provider, you may be subject to the full fee unless otherwise arranged. Please contact support if you have questions on this. If you need us to change the card we charged payment on, and did not let us know 24 hours before your appointment, a 6% processing fee is added to your charge. This is because Stripe charges us to refund/rerun it :) ps -- No we aren't money hungry and yes we want you to have services, we just are all trying to make a living doing this..if you weren't getting paid when you went to work, would you still go? Notice of Privacy Practices: Revised April 15, 2025 I. Covered Entity Duties and Key Terms Paperflower Psychiatry, LLC is a Covered Entity as defined under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), including its amendments under the HITECH Act. We are required by law to maintain the privacy of your protected health information (PHI), provide you with this Notice of our legal duties and privacy practices, and notify you in the event of a breach of unsecured PHI. Key Terms: PHI (Protected Health Information): Any health-related information that identifies you. Provider: Any licensed mental health professional under the employment or contract of Paperflower Psychiatry. Treatment, Payment, and Health Care Operations (TPO): Treatment: Coordination or management of your care. Payment: Billing or reimbursement activities. Health Care Operations: Administrative functions like quality improvement, internal training, audits, or business oversight. Use: Refers to activities within Paperflower Psychiatry (e.g., analyzing or storing PHI). Disclosure: Refers to sharing PHI outside our organization (e.g., with another provider or third-party service). II. Telehealth, AI, and International Data Use Paperflower Psychiatry uses telehealth platforms, artificial intelligence (AI)-supported tools, and international Virtual Medical Assistants (VMAs) for certain operational, billing, scheduling, and support tasks. Telehealth: We use secure HIPAA-compliant platforms for virtual care. Your information may be transmitted electronically for diagnosis, treatment, or consultation purposes. AI Tools: Limited AI-based systems may be used for scheduling, transcription assistance, or internal data review, but do not make clinical decisions or access your full PHI without oversight. 4/15/25, 10:55 PM Form Questions https://cylinder-perch-4ktn.squarespace.com/config/scheduling/forms.php?action=edit&id=2369461 1/3 International Staff: Our administrative and billing support team includes VMAs based in the Philippines. All such staff are bound by strict Business Associate Agreements (BAAs), HIPAA regulations, and applicable Philippine data privacy laws. Safeguards: All electronic PHI (ePHI) is handled through encrypted platforms. Passwords, device access, and data backups are strictly monitored and logged. III. Uses and Disclosures Requiring Authorization Your provider may only release your PHI for purposes not covered by TPO with your written authorization. You may revoke your authorization at any time in writing, except when: Your provider has already acted in reliance on it, or The authorization was a condition of insurance coverage. IV. Uses and Disclosures Without Consent or Authorization Your provider may disclose PHI without prior authorization in the following legally mandated or safety- related situations: Child or Vulnerable Adult Abuse Judicial or Administrative Proceedings Serious Threat to Health or Safety Worker’s Compensation Appointment Reminders or Treatment Alternatives For a full list of disclosures permitted without consent, contact our Privacy Officer. V. Your Rights As a patient, you have the right to: Request Restrictions on disclosures (though we may not be able to comply). Receive Confidential Communications at an alternative location. Inspect and Copy your mental health and billing records. Request Amendment of incorrect or incomplete information. Receive an Accounting of Disclosures. Revoke Authorizations (as noted above). Obtain a Paper Copy of this notice, even if received electronically. 4/15/25, 10:55 PM Form Questions https://cylinder-perch-4ktn.squarespace.com/config/scheduling/forms.php?action=edit&id=2369461 2/3 VI. Complaints If you believe your privacy rights have been violated, you may: Contact Our Privacy Officer: Elizabeth Odhner, PMHNP Email: liz@paperflowerpsychiatry.com You may request a formal complaint form at any time. All complaints will be reviewed and investigated within 60 days. File a Complaint with HHS: Visit: www.hhs.gov/ocr/privacy/hipaa/complaints You will not be retaliated against for filing a complaint. VII. Changes to Privacy Practices This notice is effective as of May 5, 2023 and was revised on April 15, 2025. Paperflower Psychiatry, LLC reserves the right to revise this notice at any time. If we do, the revised version will apply to all current and past PHI and will be posted on our website Ketamine Policies -- coming soon

Meet Delfina, the dedicated practice manager at Paperflower Psychiatry in Arizona, USA. Learn about her role and contributions to our thriving mental health practice. Delfina Honne Prior to taking our offer to help us at Paperflower, Delfina has been well-known for working as the most fantastic case manager for well over a decade at Arizona Children's Association. She knows the AZ mental health system and all of the resources. You'll never meet another person with as huge of a heart and as dedicated to her patients as Delfina! She may have sat in on Maria's first ever day as a prescriber as emotional support :) She means a lot to us here! Delfina also works at another local mental health office as a Spanish interpreter. Delfina lives in Phoenix, Arizona with her husband, her mom and the most amazing Frenchie named Romeo... Romeo may have a passport and be an international star. You'll have to ask her about Romeo! delfina@paperflowerpsychiatry.com Oversees Practice, Patient Concerns & Students QB & Tova Testing Patient Assistance & Community Events

Meet Meghan Orbegoso, MSN, PMHNP-BC, a compassionate Psychiatric Nurse Practitioner offering expert care and psychiatric medications in Tempe, AZ. Dr. Meghan Orbegoso, DNP, PMHNP-BC Hi! I’m Meghan, but feel free to call me Meg or Dr. O. I am a psychiatric nurse and nurse educator with many years’ experience in most mental health settings including outpatient, voluntary inpatient, court ordered inpatient, SMI populations, psychiatric urgent care and crisis units. I work at Phoenix Children’s inpatient psych unit and float to the behavioral health area in the emergency department. I also teach mental health specialty for nursing students. I chose to go into education and become a nurse practitioner because I am determined to be the change I want to see in the world. During my nursing education and nurse practitioner education journey, there were no instructors that looked like me or looked like anyone that I grew up with or that I felt could relate to BIPOC, first-generation, or even to barriers of social determinants of health. My family background is Peruvian and my husband is Dominican and we love to EAT! We love trying new dishes and cuisines we have not tried yet so please share any recommendations! Our toddler is still in his chicken nuggets only phase, but he will hopefully see the light and seasoning by his ancestors soon. When I’m not working or spending time with family, I like to dissociate in light-hearted media including YouTube, mobile games, fan-fictions, anime, and BBC’s 1995 Pride and Prejudice. I stay informed and therefore stay away from fictional media that is serious; the real-life state of the world is drama enough! Child/Adolescent With a focus on child and adolescent mental health, Meg is dedicated to helping young people and their families navigate challenges with confidence and understanding. She provides clear, practical guidance tailored to each child’s developmental stage, ensuring both emotional well-being and safety. Her supportive approach fosters resilience, open communication, and a strong foundation. Neurodivergence While Meg is not yet trained in diagnosing Autism, she is phenomenal at offering neuroaffirming care. She takes time to learn each person’s unique strengths, challenges, sensory needs and communication styles. Anxiety & Mood Meg offers a comforting presence and the ability to help navigate anxiety, depression, irritability, and pediatric bipolar disorder. Her therapeutic style blends evidence-based strategies with compassionate listening and empathy. Families and children alike appreciate her calm demeanor and commitment to creating a safe, supportive environment for healing and growth. Q&A What is your favorite movie? Lion King Favorite superhero? Class C Hero - Saitama! If you could have a superpower, what superpower would you pick? To speak every language and always have the right words to say. If you had 3 wishes, what would you wish for? That everyone had access to mental health care, a solid support system, and a loving community. That our days and weeks and months were longer and not to get more done, but to rest, spend time, and enjoy. For everyone to feel safe, to feel seen and known, to feel they are enough, and to believe they deserve care and kindness. Tell us a fun fact about yourself: I have serious stage-fright. I don't know how I decided to become an educator and lead lectures/lessons for 50+ nursing students at a time. I know why I want to do it, but I still don't get how I manage to speak coherently while I internally panic. Tell us about your pets: I have a Pit Mix named Goose. He got his name from his honk-like kennel cough he had when we rescued him. He is a good boy What are ways beyond medication that can improve your mental health? All of the self-care activities! All of the positive lifestyle practices that make sense for you and your family and community. Connecting with nature, caring for yourself emotionally, spiritually, holistically matters. Having strong healthy relationships matter! The results from the 80+ year Harvard wellbeing study are clear: "The clearest message that we get from this 75-year study is this: Good relationships keep us happier and healthier. Period." - R. Waldinger, Director of the Harvard Study. If a patient is nervous about an evaluation, especially when talking about tough things like trauma or sexual abuse, what would you want them to know? You are safe with me. We can discuss as little or as much as you feel ready, willing, and able to share in the moment. I will not push you to disclose more than you want to. What is your philosophy on using medication to treat mental health? Are medications lifelong? My favorite medication is Therapy. It has the fewest side effects and the longest half-life. :) But really, I believe medication can be a valuable resource and tool in a client's treatment plan, but should not be considered in isolation. I want to work with you and collaborate on all aspects of mental health which includes medications and more. Whether medications are life-long will vary from client to client and from situation to situation. What are your thoughts about treating adult ADHD? I was diagnosed with ADHD in adulthood. I grew up in a family that did not believe in mental health. That struggle with executive function was just laziness and the only treatment was to "ponte las pilas" or "work harder". I had teachers from kindergarten to college say "she's smart, but she would do better if she just applied herself." I failed out two Universities and several classes in my life until I learned about mental health in nursing school. The day after the first lecture on mental health and illness I scheduled a psychiatric evaluation. I was expecting a diagnosis of anxiety and ended up learning I was depressed and struggled with ADHD. I started treatment and the world opened up. I went from failing and being withdrawn due to academic performance to graduating with 3.8 for my Bachelors and Doctorate degrees. I have a lot of thoughts and feelings when it comes to adult ADHD. A wonderful psychiatric nurse practitioner diagnosed me and still manages my treatment and I look forward to helping my future clients in their journey. Yes, I shared a bit about my experience with adult ADHD in the previous question. In that first psychiatric evaluation, I learned I also had been struggling with depression. I remember being told that it was not normal to constantly feel like a burden and having negative thoughts playing on a loop in your mind. I was shooketh! And let me tell you when I started my first antidepressant and the negative thoughts slowed and eventually stopped! Flabber-fucking-ghasted! Because what do you mean I just needed store bought serotonin to stop feeling like a constant burden!? Witch-craft! Brujeria! And I love it! I want to help others also realize they are worthy of taking up space! I want you to man-spread to the heavens (figuratively of course, but also you do you!) with how comfortable you are with taking up space and knowing you deserve care, you deserve kindness, and you deserve to feel and know that you are enough just as you are :)

Meet Ally Stuart, a board-certified psychiatric nurse practitioner at Paperflower Psychiatry specializing in medication management, health at every size care, functional medicine and postpartum mental health. Offering compassionate care for children, teens, and adults in Phoenix and beyond. Accepting new patients. Ally Stuart, MSN, PMHNP-BC, PMH-C Ally is a board-certified Psychiatric Mental Health Nurse Practitioner with a Perinatal Mental Health Certification. She has been a nurse for over seven years, specializing in psychiatry. While she is not new to mental health, Ally has spent many years in the behavioral health field, working as a counselor, case worker, and program supervisor. Ally pursued her graduate degree to create a more collaborative client-provider relationship within a company whose values align with her own. She takes a comprehensive approach to treatment, incorporating therapy, lifestyle modifications, supplements, and, when appropriate, medication. Her goal is to provide compassionate, responsible psychiatric care—not just quick fixes—so that patients receive the support they truly deserve. Ally fosters authentic relationships with her clients, encouraging them to take an active role in their treatment. Ally currently resides in the Phoenix, AZ area with her spouse and child. Outside of work, Ally has a love affair with farmer's markets, small coffee shops, and bakeries. She loves going on cruises and traveling and would love to discuss your upcoming vacation itineraries. Perinatal Care Health at Every Size Functional Psychiatry Ally holds a perinatal mental health certificate and is excellent in offering care in pregnancy planning, IVF, pregnant and postpartum patients. If you've ever faced discrimination over your weight or worried about being told the solution is to "lose weight" -- Ally gets it and is not about that type of care. Ally has completed additional training in functional psychiatry in order to offer holistic supplement and other recommendations to complement your healing journey. Q&A What is your favorite movie? I am not much of a movie-goer since I can't seem to sit through an entire film, but give me a good series any day. I just finished Workin' Moms (let's not even talk about THAT cliffhanger of Season 6). Coming from the basic 'bee' side of me, I will happily watch any cooking challenge series or home design show. The Great British Baking Show!! Jolly good. Favorite superhero? Right now- Bernie Sanders and AOC If you could have a superpower, what superpower would you pick? Okay, so I have given this a lot of thought. The first one would be to be able to apparate (HP fan?? Anyone?) so I could bypass having to go to the airport. Second would be the ability to always have exact change in my pocket for any purchase that I made. Favorite bands/singer? The Rocket Summer and Jack's Mannequin. I'm also a Swiftie. If you had 3 wishes, what would you wish for? 1. A government that actually gave a flying fuck about their country and the people that live in it. 2. A really good brand new commercial espresso machine in my house. 3. World Peace (*Name that movie*) What is your favorite food? I love food. Sushi, enchiladas, falafel. Let's talk Crumbl Cookies and curry dishes, please. Samples at Costco for lunch, don't mind if I do. Oh and coffee (in case you haven't caught that yet)-- iced lattes and cold brew!! If you know of a cute coffee shop or bakery that I need to try -- please tell me. What are you most passionate about in the mental health field? When it comes to mental health, I truly think that getting to know who you are as a whole person is one of the most important things that can happen. You are a person who has endured magical, painful, exciting, and hard things. You are more than just symptoms, and answers don't always just lie in prescriptions to cover up these symptoms. Mental health is a whole-body experience and a journey not merely a destination. What are some experiences you have had that make you unique? unique? My husband and I went through the IVF process to start our family so I understand the intense and heart- wrenching experience that this is. It pushes you emotionally and physically in ways that I never imagined with no guarantees in the end. It's like being a part of a community you never asked to be a part of but you meet some pretty amazing people nonetheless. What is your philosophy on using medication to treat mental health? Are medications lifelong? Does a patient who sees you HAVE to be on medication? I think using medication to help with treatment is just a piece of an overall picture. Medications are definitely not meant to be lifelong. My philosophy is to provide you with all the best information I can to allow you to make an informed and comfortable choice for yourself whether that is incorporating medication into your treatment or not. If a patient is nervous about an evaluation, especially when talking about tough things like trauma or sexual abuse, what would you want them to know? Talking about tough things, especially trauma can be so difficult, especially when you're just meeting with a new person for the first time. Trauma can be messy and confusing and can be hard to make sense of. When it comes to any part of our conversations, you control what you are ready and willing to share. I am here to listen in a comforting, validating, and non-judgemental way. Do you have any personal experiences regarding mental health you are open to sharing? sharing? After I had my first baby I was very confused and scared by high anxiety and intrusive thoughts. Even being in the field for so many years I had never even heard of postpartum OCD. Now every new parent I run into I'm like "How are you REALLY doing?" and it has made me very eager to support other parents! You've mentioned being passionate about working with the Health at Every Size (HAES) population, can you tell us more about that? I live my life in a larger body. I have experienced discrimination because of my size when seeking medical care and have made a commitment as a provider to provide a weight-neutral approach to treatment. I fully recognize how diet culture is smashed into our faces virtually every day since the day we were born and how that can affect self-esteem. This can affect how we think we deserve to be treated because of our weight. We should not be afraid to go to providers because we fear they will judge or blame us or treat us less because of our size. I am a big advocate of Intuitive Eating principles and healthy, fulfilling body movement.

Meet Gillian Ilagon, the creative mind behind the compelling content at Paperflower Psychiatry. Join her journey as a content creator at Paperflower Psychiatry. Solicitar cita Conoce a Gillian Gillian Ilagon (ella/ella) Desarrollador de contenido psiquiátrico gillian@paperflowerpsychiatry.com Gillian es una profesional de la salud mental con una maestría en psicología clínica y una especialidad en asesoramiento y rehabilitación de adicciones globales. Ha pasado más de dos años como administradora de casos en un centro de rehabilitación para pacientes internados, guiando a las personas a través de la montaña rusa de la recuperación. Pero después de pasar bastante tiempo persiguiendo a clientes por el pabellón psiquiátrico, Gillian decidió cambiar el caos por algo un poco más tranquilo: el desarrollo de contenidos. Allí, podía dedicarse a su pasión y, al mismo tiempo, ayudar a la gente sin todo el drama. Ahora, su misión es crear recursos para cualquier persona que quiera entender mejor el funcionamiento interno de su mente o aprender más sobre la condición de salud mental de su ser querido. A pesar de afirmar que es introvertida, Gillian puede ser bastante comunicativa, especialmente cuando los temas giran en torno a los videojuegos, las cosas geek/nerd, el K-Pop y los gatos. Hablando de gatos, Gillian es una orgullosa sirvienta de Astra la Garra de las Sombras, la Primera de su Nombre, la Última de su Especie, Soberana de la Ventana Iluminada por el Sol, Gobernante de la Cacería de Medianoche y Guardiana del Lugar Sagrado de la Siesta. Gillian Ilagan Gillian is a mental health pro with a Master’s in Clinical Psychology and a specialty in Global Addiction Counseling and Rehabilitation. She’s spent over two years as a case manager in an inpatient rehab center, guiding people through the rollercoaster of recovery. But after enough time chasing clients around the psychiatric ward, Gillian decided to swap the chaos for something a little more chill—content development. Here, she could indulge her passion and still help people without all the drama. Now, she is on a mission to create resources for anyone looking to understand their mind’s inner workings better or to learn more about their loved one’s mental health condition. Despite claiming to be an introvert, Gillian can be quite talkative, especially when the topics revolve around gaming, geek/nerdy stuff, K-Pop, and cats. Speaking of cats, Gillian is a proud servant of Astra the Shadowclaw, First of Her Name, Last of Her Kind, Sovereign of the Sunlit Window, Ruler of the Midnight Hunt, and Keeper of the Sacred Napping Spot. Contact: gillian@paperflowerpsychiatry.com Content Creation CEU Development Patient Education

Meet Jed Pambid, the diligent billing specialist at Paperflower Psychiatry in Arizona, USA. Get to know the friendly face behind the financial operations. Conoce a Jed Solicitar cita Jerome Pambid With a robust 7 years of experience in the US Medical Billing field, I have honed my expertise in the intricate processes of claim submissions, managing rejections, addressing denials, and conducting payment postings with precision and efficiency. My career is marked by a steadfast commitment to ensuring the financial health and compliance of healthcare practices, navigating the complex landscape of medical insurance with a detail-oriented and analytical approach. Beyond my professional life, I am an ardent fan of the epic narratives and rich lore of “The Lord of the Rings” trilogy, finding solace and inspiration in the journey through Middle-earth. Similarly, the thrilling escapades of the Winchester brothers in the “Supernatural” TV series captivate my imagination, offering a blend of mystery and adventure that resonates with my own sense of exploration. Embracing the spirit of adventure that these series evoke, I cherish the opportunity to go out of town whenever possible. Whether it’s seeking the tranquility of secluded landscapes or the thrill of new experiences, these journeys are a testament to my love for discovery and the joy of stepping away from the routine to embrace the vastness of our world. Contact: billing@paperflowerpsychiatry.com Insurance Denia Insurance Claims Patient Assistance

Discover the power of community and support with our health groups in Arizona, USA. Join us to connect, learn, and thrive together. Tratamientos grupales, intensivos y residenciales Women's Health Innovations Grupos para mujeres embarazadas/postparto Grupo para construir apego seguro con tu hijo Grupos de apoyo Grupo DBT Grupo de duelo/pérdida perinatal Salud de Charlie Programa ambulatorio intensivo virtual (IOP) que dura entre 9 y 12 semanas, acepta los principales seguros y se centra en adolescentes y adultos jóvenes. Servicios de recuperación de traumas Grupo de recuperación de traumas para mujeres a partir del 14 de junio. Los miércoles por la noche de 6 a 8 p. m. Se aceptan algunos seguros, escala móvil disponible según la necesidad. EMDR/Intensivos de trauma Instituto LK Rebecca Tatum Beckstein conductual Con el corazón abierto Pájaro azul AZ Asesoramiento nacido Fructuoso AZ Grupo de apoyo para mujeres con infertilidad, gratuito y virtual. Se reúne en junio de 2023 y se reanuda en septiembre de 2023. Recuperación de la elección IOP, grupo de hombres/mujeres, arte, meditación, grupo MAT, IOP en telesalud, grupo especial para personas que puedan necesitar un trasplante de órgano. DBT Centro de Terapias Progresivas Equilibrio (mástil de bandera) Transiciones PIO para distintos grupos de edad hasta los 10 años y hasta la edad adulta avanzada. Programas de hospitalización parcial disponibles Centro de Fundamentos de Curación Psiquiatra IO de espectro completo, especializado específicamente en TEPT complejo, trastornos disociativos y otros trastornos relacionados con el trauma. CalmOCD Intensivos para TOC: actualmente hay lista de espera. Ubicado en Scottsdale. Encuentra tu brillo Terapia conductual dialéctica en adolescentes Terapia conductual dialéctica para adultos Grupo de apoyo para TOC Recuperación moderna Online IOP accepting most major commercial insurances. Servicios de Terapia Summit Grupo de yoga informado sobre traumas (flujo de 60 minutos seguido de un grupo de apoyo general de 30 minutos). Centros de tratamiento residencial Caminos de recuperación (Utah) Álamo de Tucson Sierra Tucson Lightfully (California) - adolescente + adulto