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 Intake.pdf
File Size: 2723 kb
File Type: pdf
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Consent to Treatment.doc
File Size: 116 kb
File Type: doc
Download File

Email Consent.doc
File Size: 116 kb
File Type: doc
Download File

Credit Card Authorization.doc
File Size: 109 kb
File Type: doc
Download File

Demographic Face Sheet.pdf
File Size: 1226 kb
File Type: pdf
Download File

Child/Adolescent Intake Packet (All documents are required at intake)
Child-Adolescent Intake.pdf
File Size: 3114 kb
File Type: pdf
Download File

Consent to Treatment.doc
File Size: 116 kb
File Type: doc
Download File

Email Consent.doc
File Size: 116 kb
File Type: doc
Download File

Credit Card Authorization.doc
File Size: 109 kb
File Type: doc
Download File

Demographic Face Sheet.pdf
File Size: 1226 kb
File Type: pdf
Download File

Child-Adolescent Therapy Contract.pdf
File Size: 513 kb
File Type: pdf
Download File

Minor Confirmation of Custody.pdf
File Size: 283 kb
File Type: pdf
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Reciprocal Release of Information
Release of Information 1.pdf
File Size: 1359 kb
File Type: pdf
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Release of Information 2.pdf
File Size: 80 kb
File Type: pdf
Download File

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  • Home
  • About
  • Services
  • Therapists
  • Contact
  • FORMS
  • Careers
  • Referrals & Resources