Forms

Online and downloadable forms for new and existing clients and patients.

Mental Health Forms

Forms for counseling, life coaching, mental health medication management, and other mental health services.

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Consent to Treat Minor

This form allows parents to provide consent for the treatment of a child under the age of 18.

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Release of Information

This form provides authorization for use or disclosure of protected health information.

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5-Day Intensive Program Application

Application should be completed in full and submitted at least 30 days prior to desired 5-Day Intensive Outpatient Program start date.

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Mental Health Medication Management New Patient Forms

Document to be completed prior to beginning Mental Health Medication Management

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Mental Health Medication Management Follow-up Form

Form to be completed prior to each Mental Health Medication Management Follow-up visit.

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ADHD Treatment Agreement

Agreement to be read and signed prior to beginning treatment for ADHD.

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Physical Health Forms

Forms for weight management and other health related services.

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Weight Management New Patient Information Forms

Form required to begin Weight Management services. Includes General Information, Release of Information, Consent to Treat, Payment Agreement and Information, and Health History.

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Spiritual Health Forms

Forms for spiritual health services.

There are currently no required forms for this service type.