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Blue Mountains
Blue Mountains

Helpful Forms

New patient registration forms will typically be sent as a part of the confirmation email for the initial appointment.  However, if you did not receive these forms or just need to access them again they are all available on this page for download.  New patients are required to complete the Polices & Procedures, Privacy Policy & Consent for Treatment, Background & History, and MPaCT Screening Questionnaire forms before treatment can begin.  Additional forms are also available below. 

 
New Patient Forms

  Policies & Procedures
  Privacy Policy & Consent for Treatment
  Background & History
  MPaCT Screening Questionnaire (Online Form)


   
Additional Forms

     Authorization to Release Mental Health Information
  Credit Card on File Policy
  Late Cancel & Missed Appointments Policy
  Review of Systems
  Wellness Checklist
  MPaCT Screening Questionnaire (Printed Form)


 

To download Adobe Acrobat Reader for free, click here.

 

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Helpful Forms

Click here to view and print forms for your appointment.

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