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Counseling Center at 2101 Minnehaha Ave
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Telehealth Update Letter
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Forms
Patient Registration Form – English
formulario de registro del paciente
Release of Patient Information
Telehealth Inform Consent Form
Telehealth Informed Consent From – Spanish
autorización para divulgar información del paciente
PHQ Psychiatric Form
Psychiatric Meds-Ros
PHQ-A – English
PHQ-A – Spanish
PHQ9 and GAD7 – English
PHQ9 and GAD7 – Spanish
MFPP Application
Medication Assisted Treatment (MAT) Consent Form
Health Information Exchange Opt Out – English PDF
formulario de exclusion / aceptacion de intercambio electronico de informacion de salud
COVID-19
Dental Clinic Updates for COVID-19
COVID-19 Testing
COVID-19 Response Update May 2020
Billing Updates for COVID-19
COVID-19 Response Update April 2020
COVID-19 Response Update March 2020
Privacy Practices
Notice of Privacy Practice
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