Please allow extra time during your first visit to fill out these forms.
If you are an adult , please fill out this form and bring it to the first appointment.
Consent for Treatment
Powers of Attorney will fill out this form and remit it to our offices as soon as possible.
Release of Information
Authorization for release of Mental Health, Alcohol & Drug Abuse and other personal health information
Consent for Teletherapy
Complete the “Telepsychological Services” checklist if you intend to take part in teletherapy sessions
No Surprises Letter
Download this letter to learn our responsibilty to you under the No Surprises Act.
Good Faith Estimate
Download this form for your reference and your therapist will discuss this with you.
Private Pay Contract
If you intend to pay “Out Of Pocket” (fee for service), download this form and complete it and remit it to BBHW prior to your next appointment.
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Contact us today to schedule your first appointment!