Patient Forms
Get a head start on your initial consultation by completing the document below. All documents are required in order to start you path to recovery! Get started today!
- Patient Information, Assignment of Benefits & HIPAA Acknowledgment (Download)(opens in a new tab)
- General Treatment Consent (Download)(opens in a new tab)
- Resource Assistance Screening (Download)(opens in a new tab)
- Telehealth Informed Consent (Download)(opens in a new tab)
- Counseling Consent & Limits of Confidentiality (Download)(opens in a new tab)
- Counseling Attendance Policy (Download)(opens in a new tab)
- Patient Compliance Agreement (Download)(opens in a new tab)
- Authorization for Release of Information (Download)(opens in a new tab)
- Buprenorphine-Assisted Therapy Pharmacy Acknowledgments (Download)(opens in a new tab)