Evolve Behavioral Health
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Helpful Forms

Client Forms


BRIGHTON OFFICE
All intake forms will be sent to you through our secure, HIPAA compliant electronic health record once your intake appointment is confirmed.

OKEMOS OFFICE

Adult intake packet - all forms are required for intake.

Adult Assessment (Fillable).pdf
File Size: 1208 kb
File Type: pdf
Download File

Consent to Treatment (Fillable).pdf
File Size: 93 kb
File Type: pdf
Download File

Electronic Communication Consent (Fillable).pdf
File Size: 53 kb
File Type: pdf
Download File

Credit Card Authorization (Fillable).pdf
File Size: 86 kb
File Type: pdf
Download File

Demographic Face Sheet (Fillable).pdf
File Size: 170 kb
File Type: pdf
Download File

Child/Adolescent Intake Packet (All documents are required at intake)
Child/Adolescent Assessment (Fillable).pdf
File Size: 1227 kb
File Type: pdf
Download File

Consent to Treatment (Fillable).pdf
File Size: 93 kb
File Type: pdf
Download File

Electronic Communication Consent (Fillable).pdf
File Size: 53 kb
File Type: pdf
Download File

Credit Card Authorization (Fillable).pdf
File Size: 86 kb
File Type: pdf
Download File

Demographic Face Sheet (Fillable).pdf
File Size: 170 kb
File Type: pdf
Download File

Child/Adolescent Therapy Contract (Fillable).pdf
File Size: 203 kb
File Type: pdf
Download File

Confirmation of Legal Custody (Fillable).pdf
File Size: 103 kb
File Type: pdf
Download File

Reciprocal Release of Information
Release of Information , version 1 (Fillable).pdf
File Size: 299 kb
File Type: pdf
Download File

Release of Information, version 2 (Fillable).pdf
File Size: 139 kb
File Type: pdf
Download File

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  • Home
  • About
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  • Therapists
  • Contact
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