Rio Arriba County Online Intake Forms
REQUIRED FORMS
General Intake
Medical History
Clinical Policies
Notice Of Privacy Practices
Notice Of Confidentiality Of Alcohol And Drug Abuse Patient Records
Financial Responsibility
Telehealth Consent
Proof Of Identity & Insurance
Disclosure Of Information: Primary Care Provider
OTHER FORMS
Permission For School-Based Services
Request For Services By A Minor (For Minors Only—Parents Do Not Complete)
Disclosure Of Information: General
Recording Consent