INTAKE FORMS

ALL FORMS

SIGN IN FORM

MEMBERS' RIGHTS

INFORMED CONSENT FOR TREATMENT

PATIENT CARE COMMUNICATION FORM

HEALTH QUESTIONNAIRE

REQUEST FOR OTHER FORMS OF COMMUNICATION

PRIVACY PRACTICES

NOTICES, CONSENTS, AND AUTHORIZATIONS

RESPONSIBILITIES FOR ADDITIONAL FEES

UNITED HEALTH CARE/UNITED BEHAVIORAL HEALTH CARE MEMBERS fill out these additional intake forms for adults here and for children/adolescents here. These forms will be faxed to United Health Care to ensure that you will be authorized to have the services reimbursed by your insurance company

Set Up an Appointment      Insurance Issues     Intake Forms      Questions or Comments? Contact our webmaster