Adults: All Forms
SS77
Adult Background
Intake Form
HIPAA
Information & Treatment Agreement
Patient Care Communication
Coordination of Benefits
Health Insurance Claim
Health Policy Notice
Consent to Email and Text
Consent to Telepsychology
Adolescents (13-18): All Forms
Adult Background
Intake Form
HIPAA
Information & Treatment Agreement
Patient Care Communication
Coordination of Benefits
Health Insurance Claim
Health Policy Notice
Consent to Email and Text
Consent to Telepsychology
Adolescent History (Adolescent should fill out)
Child Treatment Consent
Child Problem Questionnaire (Adolescent should fill out)
ADHD Questionnaire
Family Questionnaire
Intake Form
HIPAA
Information & Treatment Agreement
Patient Care Communication
Coordination of Benefits
Health Insurance Claim
Health Policy Notice
Consent to Email and Text
Consent to Telepsychology
UBH/UHC Clients: All Forms
Child Treatment Consent
Child Problem Questionnaire (Adolescent should fill out)
ADHD Questionnaire
Family Questionnaire
Intake Form
HIPAA
Information & Treatment Agreement
Patient Care Communication
Coordination of Benefits
Health Insurance Claim
Health Policy Notice
Consent to Email and Text
Consent to Telepsychology
Children (8-12): All Forms
Child Treatment Consent
Child Problem Questionnaire
ADHD Questionnaire
Family Questionnaire
Intake Form
HIPAA
Information & Treatment Agreement
Patient Care Communication
Coordination of Benefits
Health Insurance Claim
Health Policy Notice
Consent to Email and Text
Consent to Telepsychology
Children (0-7): All Forms
Child Problem Questionnaire
ADHD Questionnaire
Family Questionnaire
Intake Form
HIPAA
Information & Treatment Agreement
Patient Care Communication
Coordination of Benefits
Health Insurance Claim
Health Policy Notice
Consent to Email and Text
Consent to Telepsychology