BH Providers.com Intake Forms

Directions:

Cary	(Driving Directions)
Geneva	(Driving Directions)

You will need
Adobe Acrobat Reader
to view the Intake Forms.
If you do not have this
program click here

to download a free
version of the Reader.

Intake Forms

In an attempt to make your initial session go as efficiently as possible we now have our required intake forms available online in a PDF format. Please fill out all the forms that apply to your situation as completely as you are capable of doing before your first session. Once your form is completed either print it out and sign it; or, email it back to BHP and sign it when you show up for your first scheduled appointment.

Click here for the all of the Intake Forms

or complete them separately...

Click here for the General Information Form	Click here for the Financial and Treatment Policy Form	Click here for the Physician Notification Consent Form	Click here for the Minor Consent Form
This form must be completed by every patient of BHP	This form must be completed by every patient of BHP	This form must be completed by every patient of BHP	This form must be completed only by the parent or guardian of patient's under the age of 18

After you have completed and saved the appropriate file(s) attach it (them) in an email and return your forms to us at: B.H.P@comcast.net

Now call BHP (1-888-291-2538) to receive an appointment time and date.

All information you provide Behavioral Health Providers, P.C. is private and secure;
this information will only be used for clinical and billing purposes.