Forms & Consents

For new clients, we require consents and intake forms be completed before your first appointment. This makes for the most productive initial visit and ensures that the best care plan can be developed for you.

The consent forms can be sent and completed electronically prior to your appointment, but are here for your convenience as well.

Client Intake Form - Adult

Client Intake Form - Child

Patient Agreement and Consent to Treatment

Authorization for Electronic Communication Consent

Authorization for Telehealth Consent

Authorization for Release of Health Information (ROI), if applicable.
Complete one ROI for each: prior mental health provider, any recent hospitalizations, your primary care provider if they have prescribed medications for mental health, and any other providers necessary. You may also complete one for anyone you wish me to release information to such as spouse, support/family member, or others involved in your care.

If you have any questions about the documents or consents, please contact Bluebird Behavioral Health for assistance.