Forms

Welcome to Adult & Child Health! Here’s your one-stop shop for the forms you’ll need to fill out to begin utilizing services. If you have questions, please call 1-877-882-5122.

Consent form

Consent form (Spanish)

Financial Assessment form

Adult New Patient Clinical History form

Adult New Patient Clinical History form (Spanish)

Youth New Patient Clinical History form

Youth New Patient Clinical History form (Spanish)

Treatment Plan Signature Page – Client With Guardian

Treatment Plan Signature Page – Client without Guardian

Click here to find Foster Care forms.