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Client Forms for Phoenix Behavioral Health Services, LLC


To make an appointment, call us at 920-657-1780 or fill out and submit our Contact Us form.

Please print and fill out the following forms to bring along on your first visit to our office. Also, remember to bring a picture ID and insurance card(s).

All forms are Adobe PDF files. If you have trouble viewing the forms you need, you may need to download and install the free Adobe Reader application.


New Patient Forms (Adult)

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  • New Patient Information Form
  • Payment and Credit Policy/Patient
  • Client Informed Consent & Acknowledgement of Program
  • Policies and Procedures
  • Medication History
  • Intake and Assessment
  • Inventory Assessment (BDI)

New Patient Forms (Child)

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  • New Patient Information Form
  • Payment and Credit Policy/Patient
  • Client Informed Consent & Acknowledgement of Program
  • Policies and Procedures
  • Medication History
  • Child Intake Form

We are here to help, contact us for an appointment.