Client Intake Forms

Client Intake Forms

Please find links below to all of our Client Intake Forms in PDF format. It is advised that clients download and bring in completed forms to their intake appointment along with appropriate insurance information. If you have any questions or need assistance, please call (505) 830 1871.

1. General Intake
2. Medical History
3. Clinical Policies
4. Notice Of Privacy Practices
5. Notice Of Confidentiality Of Alcohol And Drug Abuse Patient Records
6. Disclosure Of Health Information
7. Permission For School-Based Services
8. Notice Of Confidentiality Of All Records
9. Request For Services By A Minor