Forms & Documents > Client Application_Intake Forms > BH Shared Intake Forms

Name Description Type Action
Application-for-Services_English_11-30-12 Application for Services File Download
Solicitud-de-servicios_11-30-12 Solicitud de servicios_11-30-12 File Download
Consent-for-Treatment_English_5-20-15 Consent for Treatment File Download
Consentimiento-para-Tratamiento_5-20-15 Consentimiento para Tratamiento File Download
Cost-Explanation-and-Agreement_5-27-2015 Cost Explanation and Agreement File Download
Explicacion-de-Costo-y-Acuerdo_5-27-15 Explicación de Costo y Acuerdo File Download
Health-Questionnaire-2014 Health Questionnaire File Download
Cuestionario-de-salud_12-14 Cuestionario de salud File Download
Notice-of-Privacy-Practices_English_5-2017 Notice of Privacy Practices File Download
Aviso-de-Practicas-de-Privacidad_5-2017 Aviso de Practicas de Privacidad File Download