Adults: All Forms
SS77
Adult Background
COVID-19 Consent
Intake Form
HIPAA
Information & Treatment Agreement
Patient Care Communication
Coordination of Benefits
Health Insurance Claim
Health Policy Notice
Adolescents (13-18): All Forms
Adult Background
COVID-19 Consent
Intake Form
HIPAA
Information & Treatment Agreement
Patient Care Communication
Coordination of Benefits
Health Insurance Claim
Health Policy Notice
Adolescent History (Adolescent should fill out)
Child Treatment Consent
Child Problem Questionnaire (Adolescent should fill out)
ADHD Questionnaire
Family Questionnaire
COVID-19 Consent
Intake Form
HIPAA
Information & Treatment Agreement
Patient Care Communication
Coordination of Benefits
Health Insurance Claim
Health Policy Notice
UBH/UHC Clients: All Forms
Child Treatment Consent
Child Problem Questionnaire (Adolescent should fill out)
ADHD Questionnaire
Family Questionnaire
COVID-19 Consent
Intake Form
HIPAA
Information & Treatment Agreement
Patient Care Communication
Coordination of Benefits
Health Insurance Claim
Health Policy Notice
Children (8-12): All Forms
Child Treatment Consent
Child Problem Questionnaire
ADHD Questionnaire
Family Questionnaire
COVID-19 Consent
Intake Form
HIPAA
Information & Treatment Agreement
Patient Care Communication
Coordination of Benefits
Health Insurance Claim
Health Policy Notice
Children (0-7): All Forms
Child Problem Questionnaire
ADHD Questionnaire
Family Questionnaire
COVID-19 Consent
Intake Form
HIPAA
Information & Treatment Agreement
Patient Care Communication
Coordination of Benefits
Health Insurance Claim
Health Policy Notice