Patient Forms
Please bring your completed forms with you to our office at the time of your visit. To view the documents listed on this page, you will need Adobe Reader.
Online questionnaires can be completed through your MyChart Patient Portal when it is associated with a visit.
Release Forms
- Authorization to Release Health Information
For Transfers Out, Transfers In, Copy for Self and Coordination of Care with family or schools - Authorization for to Release Medical Information to Family Members
For patients 18 years old or older to share information with family members - Authorization to Release Sensitive Health Information
For sensitive information like HIV/AIDS, Genetic Information, Alcohol and/or Drug Abuse or Sexually Transmitted Diseases - Authorization to Release Behavioral Health Information – Two Way Communication – English
Authorization to Release Behavioral Health Information – Two Way Communication – Spanish
For therapists and facilities to have 2 way conversation with our integrated behavioral health team and providers - Authorization to Release Psychotherapy Notes
For requesting integrated behavioral health notes from NAP