Patient Forms

Primary Care Registration/Formulario De Inscripción Del Paciente

Consent Form

Age of Consent Info Letter

Edad de consentimiento médico y de salud conductual

Student Needs Form English/Spanish

Pediatric Behavioral Health Intake – 2nd Parent Informant

Pediatric Behavioral Health Intake — Teacher Informant

Covid Testing Patient Registration Form

Mental Health Intake Form

Consumer Acknowledgments and Consent to Treatment

Notice of Privacy Practices – English

Notice of Privacy Practices – Spanish

Client Notifications

Notificaciones al paciente acerca del tratamiento de salud conductual

Patient Concern Form

Authorization to Release Medical Information to Outside Entity

Autorización Para Divulgar Información A Una Entidad Externa

Authorization to Release Medical Information to Rogue Community Health

Autorización Para Obtener Información Médica

Consent to Use or Disclose Medical Info

Vaccination Consent Form

English

Spanish