Printable 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.

General Intake
Medical History
Clinical Policies
Notice Of Privacy Practices
Notice Of Confidentiality Of Alcohol And Drug Abuse Patient Records
Receipt Of Notice Of Privacy Practices
Disclosure Of Health Information
Permission For School-Based Services
Request For Services By A Minor
Financial Responsibility