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.

Complete Online Form

Download PDF Form

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Release of Information

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

Complete Online Form

Download PDF Form

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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.

Complete Online Form

Download PDF Form

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Mental Health Medication Management New Patient Forms

Document to be completed prior to beginning Mental Health Medication Management

Complete Online Form

Download PDF Form

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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.

Complete Online Form

Download PDF Form

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ADHD Treatment Agreement

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

Complete Online Form

Download PDF Form

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.

Complete Online Form

Download PDF Form

Spiritual Health Forms

Forms for spiritual health services.

There are currently no required forms for this service type.